Arthritis has a “geriatric” connotation, yet it may affect any age group. The term means joint disease/ disorder. Arthritis can be due to many causes such as degeneration or destruction that is age-related or trauma related, infectious, inflammatory, and/or autoimmune.  Rheumatoid arthritis is an autoimmune related arthritis affecting the neck, back and limb joints. Acupuncture has been used as an adjunctive treatment for rheumatoid arthritis. This post is about Chiropractor West Palm Beach: Acupuncture for Rheumatoid Arthritis.

Rheumatoid Arthritis is an Autoimmune Disorder

Rheumatoid Arthritis is an autoimmune disorder causing an inflammatory arthritis occurring mostly in 25-55 year old women. The common joints involved are hand, ankle, foot, toes, wrist, knee, elbow, shoulder (glenohumeral joint, acromioclavicular joint), neck (atlantoaxial joint, first and second cervical vertebrae of spine) and hips (femoracetabular joints).  

Rheumatoid Arthritis often starts as finger or wrist pain. The joints involved most frequently are the proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints of the (base of) hands. You may feel the joints are swollen and that in the morning it takes over an hour to be able to move the fingers comfortably. Furthermore, you may feel fatigue and have possible weight loss. 

So pain, warmth and associated periarticular (around the joint) soft tissue swelling, stiffness, and range of motion restrictions are signs and symptoms. Also at some point, the body or limb will be affected bilaterally (both sides).

Cause 

Rheumatoid Arthritis is an autoimmune disorder causing an inflammatory arthritis. What happens is the joint forms a reactive pannus. And the pannus is a hypertrophied synovium (overgrowth of lining of joint).  This pannus invades and erodes contiguous (nearby) cartilage and bone, causing swelling and eventual erosion. Finally, later changes include flexor (finger folding soft tissue) contractures and ulnar deviation (bend abnormally toward your little finger) of the fingers.

Multiple genetic and environmental factors have been associated with an increased risk for rheumatoid arthritis (RA). Associations have been seen with being female, a family history of RA, and with exposure to tobacco smoke.

Also, if you possess the class 2 human leukocyte antigen (HLA), you have a genetic predisposition to getting Rheumatoid Arthritis (RA). Observations in studies show that HLA genes play an important role in the etiopathogenesis (cause and development of disease) of  RA. Scientists say the genes provide a sort of ‘prearthritic’ immunological background on which the triggering factors for RA thrive.

What is autoimmune arthritis?

 Firstly, inflammatory arthritis is due to an autoimmune disease. The immune system doesn’t work properly and releases inflammatory chemicals. Secondly, the resulting inflammation attacks joint tissues and can cause joint swelling, cartilage/bone damage, and muscle loss. Thirdly, the inflammatory chemicals may activate nerves around the joints and other parts of the body and lead to pain as well. Lastly, because most of the inflammatory forms of arthritis are systemic (effects entire body), symptoms related to inflammation may occur in other parts of the body, including skin rashes, eye inflammation, hair loss, dry mouth, and fever.

Inflammatory arthritis includes a group of arthritis accompanied by joint pain, swelling, warmth, tenderness in the joints, and morning stiffness that lasts for an hour. And joints affected are many joints throughout the body at the same time.  Moreover, inflammatory forms of arthritis are much less common than osteoarthritis (wear and tear arthritis), which affects most people at the later stages of life. 

 

 Laboratory Findings 

Rheumatoid Factor

A positive rheumatoid factor test result indicates that a high level of rheumatoid factor was detected in your blood. A higher level of rheumatoid factor in your blood is closely associated with autoimmune disease, particularly rheumatoid arthritis. A positive rheumatoid factor (IgM antibody) is found in 75% of people with Rheumatoid Arthritis. A rheumatoid factor test is the most useful test to diagnosis rheumatoid arthritis. 

Additional findings are:

-Lab testing will reveal elevations in erythrocyte sedimentation rate (ESR) in Rheumatoid Arthritis cases.

-The CRP test measures the level of C–reactive protein which may be higher due to inflammation. 

-Anemia develops in autoimmune disease such as Rheumatoid Arthritis and is found in the Complete Blood Count (CBC test). 

Imaging and X-Ray

 Radiographic (x-ray) findings usually confirm the diagnosis. However, these are not evident in the early stages of the disease.

 Juvenile Rheumatoid Arthritis

Juvenile means the disease starts around ages 5-10 years old. Juvenile Rheumatoid Arthritis has the same findings as adult Rheumatoid Arthritis.  Common joints involved are hand, foot, wrist, knee, elbow, heel, hip, and cervical spine (neck). Lab work is similar to the adult type with the addition of urinalysis, and other laboratory tests.

Imaging and X-Ray 

Radiographic (x-ray) findings are similar to the adult type with the possible addition of growth disturbances of  bone and epiphyseal (growth plate of bone) injuries due to the autoimmune disease.

 

Treatment for Rheumatoid Arthritis

Conventionally, RA is treated with NSAIDs, csDMARDs (immunosuppressive medications), glucocorticoids (steroids), and biologics (drugs from natural substances). However, when longtime medications are given for treatment, patients get side effects. Such side effects can be malignancy, immunosuppression, liver damage, bone marrow dysfunction, life-threatening infections, hyperglycemia, interstitial lung disease, and hypertension. Therefore, patients often look for alternatives such as acupuncture.

Chiropractor West Palm Beach: Acupuncture for Rheumatoid Arthritis

Firstly, “available evidence suggests that acupuncture is beneficial for relieving pain and ameliorating quality of life and health index in patients with RA. Thereby, it should be available as an adjunctive nonpharmacological treatment in rehabilitation programs.” (1)

Secondly, studies suggest that acupuncture may work by stimulating the natural opioid (endorphins) system in the body. Additionally, this would provide feelings of well being.  Being so ill all the time can lead RA patients into depression.

Thirdly, in another study, acupuncture positively affected the hypothalamus-pituitary-adrenal connection. This is the body’s primary, long-term stress response system.   Also, acupuncture provides a nonanalgesic (not a pain reliever) effect mainly by suppressing the inflammatory response, improving blood flow, and relaxing muscle tone.

Fourthly, Acupuncture works by stimulating certain points on the body known as acupoints. It works by insertion and twisting of thin needles to achieve therapeutic results. Indeed, acupuncture changes or prevents “the perception of pain”. Furthermore, acupuncture treats certain diseases or physical dysfunction this way. 

 

Chiropractor West Palm Beach: Acupuncture for Rheumatoid Arthritis

Acupuncture has been used for over 4000 years to treat pain and other health problems safely and effectively. The acupuncture treatment stimulates the pathways called meridians. This activates the body’s natural healing abilities.  Ultimately, this brings balance back to your body. Acupuncture has a beneficial effect when treating many diseases and painful conditions.

Meiri Chiropractic offers acupuncture for Rheumatoid Arthritis and many other ailments. Dr. Natalie Meiri is a chiropractic physician, board certified in acupuncture with over 20 years of experience.  Call 561-253-8984 today.

 

 References: 

Evid Based Complement Alternat Med

. 2022 Apr 30;2022:5264977. doi: 10.1155/2022/5264977

Clinical Efficacy of Acupuncture for the Treatment of Rheumatoid Arthritis: Meta-Analysis of Randomized Clinical Trials

 

 

 

From Dr. Natalie Meiri’s clinical pearl stories:  Chiropractor West Palm Beach: Relief From Piriformis Syndrome With Acupuncture

This is my clinical pearl story about Chiropractor West Palm Beach: Relief for Piriformis Syndrome with Acupuncture.  He was a 40 year old male patient.  His chief complaints were buttock and posterior (back) leg pain.  And it came on insidiously (gradual, subtle but with harmful effects) without any trauma.

To be HIPAA compliant, I will call him Marty instead of his real name.

Marty worked as a truck driver.   One day he presented to my office reporting pain in the gluteal region. It was characterized as shooting, burning, or aching down the back of the leg. In addition, he reported numbness in the buttocks and tingling sensations. And it was along the distribution of the sciatic nerve.

He had seen his primary care physician and had his low back x-rayed.  The pain medication his primary prescribed didn’t help at all.  So that’s when he decided to come see me.

 

Marty’s Examination at Meiri Chiropractic

Upon examination, Marty tested positive for the piriformis syndrome.  His x-rays taken at the primary care doctor showed degenerative arthritis (osteoarthritis). Marty’s diagnosis was Piriformis Syndrome. 

Piriformis syndrome occurs due to sciatic nerve entrapment at the level of the ischial tuberosity (“sit bone”).

 

What is Piriformis Syndrome?

Firstly, the piriformis is a flat, pear-shaped muscle located in the gluteal (buttock) region of the hip/proximal thigh.

Secondly, the sciatic nerve runs under the piriformis muscle where it may be compressed (pinched) by the piriformis muscle. As the biggest nerve in your body, it originates from several nerves in your lower back. These nerves branch outward from the spine and then come together at each buttock to form the sciatic nerve, which then travels down each leg. And sciatica is defined as irritation or compression of the sciatic nerve that causes pain in the buttock area with radiation to the lower leg. This is usually a neuritis (inflammation of a nerve) and generally caused by mechanical compression or irritation of the lumbar and sacral spinal nerve roots.  However, piriformis syndrome is another cause of irritation of the sciatic nerve.

Thirdly, predisposition to piriformis syndrome may be due to an anatomically short leg (one leg is structurally shorter than the other due to bone length differences).  Other reasons could be due to excessive pronation (inward rotation of foot) of your foot or a pelvic rotation/misalignment.

Fourthly, in approximately 15 % of the population, there are two muscle bellies (bipartite) to the piriformis muscle.  In this case, the sciatic nerve courses between the 2 muscle bellies.

 

Causes of Piriformis Syndrome

• Trauma to the hip or buttock area
• Piriformis muscle hypertrophy (often seen in athletes during periods of increased weightlifting requirements or pre-season conditioning)
• Sitting for prolonged periods (truck drivers, office workers, bicycle riders)
• Anatomic anomalies (abnormalities) and sciatic nerve coursing:
  • In >80% of the population, the sciatic nerve courses deep to and exits inferiorly (below) to the piriformis muscle belly/tendon

Marty’s Acupuncture Treatments at Meiri Chiropractic

Marty decided to try a course of acupuncture treatments (1-2 times a week for 12 weeks).  

His acupuncture treatments consisted of the insertion of very thin metal needles.   

Marty reported that he was starting to feel better after the initial visit.  After 12 visits, he was mostly pain-free.  

 

Chiropractor West Palm Beach: Relief for Piriformis Syndrome with Acupuncture 

Firstly, Acupuncture is a treatment that has been used for over 4000 years to treat pain and other health problems. It is a painless technique used to affect what the ancient chinese practitioners called Meridians (energy channels) in your body under the skin.

Secondly, Acupuncture’s effectiveness has been well documented in musculoskeletal pain disorders and other ailments. A widely accepted contemporary medical treatment option for myofascial pain is trigger point needling. In traditional Chinese medicine, these myofascial pain areas are called ASHI points. ASHI points are identified by tender, painful reactions upon palpation (using hands to examine body).

Thirdly, the Acupuncture treatment stimulates the imbalanced pathways along the meridians to bring balance back.  The goal is to activate the body’s natural healing abilities. 

 

 

Chiropractor West Palm Beach: Relief for Piriformis Syndrome with Acupuncture: Research

One study compared the difference in clinical efficacy on piriformis syndrome between trigger-point acupuncture and glucocorticoid injections (steroid shots).  Findings were, “The clinical effect of acupuncture is similar to that of glucocorticoid injection on piriformis syndrome in 1 month after treatment. In 2 months after treatment, TrP acupuncture is markedly effective for attenuating pain and the functional impairment of the lower limbs, improving the quality of life and reducing the use of analgesic drugs in comparison with glucocorticoid injection”.

Ultimately, Acupuncture treatments stimulate the imbalanced pathways along the meridians to bring balance back.  Moreover, the goal is to activate the body’s natural healing abilities. It’s often used to manage pain and other conditions, and can be part of a broader approach to healthcare. By combining the appropriate meridians, acupoints and the ashi points corresponding to the piriformis muscle, piriformis syndrome is effectively treated.

 

Chiropractor West Palm Beach: Relief for Piriformis Syndrome with Acupuncture

Meiri Chiropractic offers acupuncture for piriformis syndrome and many other ailments. Dr. Natalie Meiri is a chiropractic physician, board certified in acupuncture with over 20 years of experience.  Call today for your acupuncture treatment. If you have pain due to piriformis syndrome  call us today at 561-253-8984!  Ask to make an appointment or find out more about: Chiropractic West Palm Beach: Relief for Piriformis Syndrome with Acupuncture.

 

References:

1. Thomas Souza, (2018) Differential Diagnosis and Management for the Chiropractor
2. Clinical study of piriformis syndrome treated with trigger-point acupuncture, Li-xue LIU, Miao-miao SHEN, Qin-ge WANG, Wen SHEN, https://www.sciopen.com/article/10.13702/j.1000-0607.20230336

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21.6% of those with drug disorders have an opioid disorder. And this includes prescription pain relievers or “painkillers” and heroin). 70.5 million or 24.9% of people 12 and over have used illegal drugs or misused prescription drugs within the last year. Tobacco use, particularly cigarette smoking, remains a leading cause of preventable disease and death in the United States. Accidental drug overdose is a leading cause of death among persons under the age of 45. Despite efforts to stop all the above, a significant portion of the population still has these problems.

Drug addiction is a chronically relapsing disorder, affecting people from all over. Fortunatelyl, studies of acupuncture effects on drug addiction show that acupuncture can be used for treating drug addiction by direct activation of brain pathways. This blog is about Chiropractor West Palm Beach: Acupuncture Helps You Overcome Addiction.

 

Substance Abuse, Addiction and Acupuncture

Firstly, substance abuse and addiction are universally recognized as diseases that disrupt and damage neurotransmitters in the brain.  Ultimately, this causes a disturbance to production levels of chemicals.   Without improvement, the feelings of anxiety, depression, and mood swings results in an uncontrollable compulsion to consume the substance of addiction. Following an acupuncture treatment, our body’s enkephalins and endorphins are released.  These are our body’s natural opioids and can dramatically relieve pain.  Additionally, once these neurotransmitters are moving about, our blood vessels vasodilates. And this gets blood into the affected areas, initiating healing.

Secondly, acupuncture can help addicts work through pain holistically and learn healthy alternatives for pain management.  Indeed, pain is especially common in those suffering from prescription drug addiction, and often leads people to abuse medications in an attempt to control discomfort.  In fact, for many individuals suffering from addiction, physical pain is one of the primary causes of substance abuse. Developing a rehabilitation plan that treats the physical and mental dependence on drugs or alcohol is important. 

Thirdly, many addicts report that, in an attempt to manage pain, they began misusing prescription pain medication.  A tolerance often builds in people who suffer from long-term pain. Therefore, they start taking more of the medication to manage discomfort. So identifying and relieving pain without the use of prescription medications is key.  Alternative therapy programs like acupuncture have shown to support and enhance the outcome of treatment for substance abuse and chemical dependence. In conclusion, Acupuncture, detox, counseling, and physical rehabilitation (e.g. chiropractic care) are all necessary elements of addiction recovery programs. 

 

Acupuncture for Detoxing

NADA stands for the National Acupuncture Detoxification Association.  NADA treatments benefit trauma, substance misuse, abuse, and mental health conditions. For example, it is an adjunct therapy for patients who are in treatment with counseling.  Indeed, NADA is a very effective auricular (ear) acupuncture treatment that has proven benefits for many addictions.

NADA treatments do the following:

• Decreases cravings for alcohol and drugs, including nicotine
• Relieves withdrawal symptoms
• Promotes calmness, better sleep, and less anxiety
• Negates stress and emotional trauma
• Allows more for filling counseling
• Encourages a more stable inner self perception

How Does Acupuncture Help Addiction Recovery?

Acupuncture may have an Analgesic effect through the release of the neurotransmitter enkephalin, which inhibits the nociceptive pathway or through the release of local endorphin.

In one study, acupuncture tended to improve more than the placebo or no-treatment group in terms of the urine test score, craving test score, efficacy rate, and blood test score studies. For example, retention was significantly higher in the group that underwent acupuncture than in the placebo group in the heroin addiction studies.

In yet another study, a review provides evidence that acupuncture may reduce relapse to drug-seeking behavior by regulating neurotransmitters involved in drug craving.  For instance, these are serotonin and dopamine, resulting in affecting the emotional state and craving. It was stated by researchers this may be the basis for the treatment of smoking cessation. (2) So our body’s enkephalins and endorphins are released.  These are our body’s natural opioids and can dramatically relieve pain.  Additionally, once these neurotransmitters are moving about, our blood vessels vasodilates. And this gets blood into the affected areas, initiating healing.

 

 

Chiropractor West Palm Beach: Acupuncture Helps You Overcome Addiction

At Meiri Chiropractic we spend the time necessary to examine, diagnose and treat every neuromusculoskeletal condition and various ailments you have.  Chiropractic and acupuncture  are holistic and natural ways to not only treat existing conditions, but to keep your body in its best working condition.  We have been offering effective treatments in Palm Beach county since 2006.  Many of our patient reviews note our excellence.  Call us today at 561-253-8984 to make an appointment or to find out more about Chiropractor West Palm Beach: Acupuncture Helps You Overcome Addiction.

 

Reference: (1) https://drugabusestatistics.org/

(2) Bidirectional role of acupuncture in the treatment of drug addiction Mi Young Lee, Bong Hyo Lee ^b, Hee Young Kim ^b, Chae Ha Yang