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mala
Hong Kong
774 Posts |
 Posted - 09/24/2008 : 17:34:35
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For anyone who is interested, this is an article by Fred Amir.
I hope all is well in your corner of the world!
Just wanted to follow up on a couple of points regarding knee and hip pain.
The following study was published in The New England Journal of Medicine on September 11, 2008.
“Background Magnetic resonance imaging (MRI) of the knee is often performed in patients who have knee symptoms of unclear cause. When meniscal tears are found, it is commonly assumed that the symptoms are attributable to them. However, there is a paucity of data regarding the prevalence of meniscal damage in the general population and the association of meniscal tears with knee symptoms and with radiographic evidence of osteoarthritis.
MRI scans obtained from 991 subjects (57% of whom were women). Symptoms involving the right knee were evaluated by questionnaire.
Results Sixty-one percent of the subjects who had meniscal tears in their knees had not had any pain, aching, or stiffness during the previous month.
Conclusions Incidental meniscal findings on MRI of the knee are common in the general population and increase with increasing age. “
So there are millions people with torn meniscus who have no knee pain.
Thus, it is clear that it is natural part of aging and blaming for the pain and operating for it is misguided. Yet it is very likely that if you go to your doctor with knee pain tomorrow, she may have you have an MRI done and once torn meniscus is found recommend surgery.
Regarding hip pain and hip replacement surgery, the following is my response to a reader:
“Dr. Sarno mentions helping some patients recover and avoid hip replacement in The Mindbody Prescription. Also one of the contributing doctors to The Divided Mind wrote about this.
In a personal communication to me Dr. Sarno wrote that in some cases hip replacement is not needed. But he did not rule out its need.
Is it one hip or both hips? If it is one, have you had imaging done of the other hip as well to see the extent of osteoarthritis? If the other hip also looks the same or worse but has no pain, that's an indication that the pain in the other hip is most likely caused by tension.
A friend of mine in his sixties was going to have his right hip replaced. His wife had done it and was doing well. He does not accept the TMS diagnosis even for back pain, however, he is a great believer in healing powers of honey and cinnamon (there are studies showing the many curative benefits of honey for infections, etc.). So he started to take them for hip pain and he recovered. Of course, his strong faith in the healing power of honey that reversed the effects of tension and conditioned response.
Please let me know what happens in your case.”
Stay informed. Stay well.
Fred Amir
www.rapidrecovery.net
Good Luck & Good Health
Mala |
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mk6283
USA
272 Posts |
Posted - 09/24/2008 : 19:09:42
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The 9/11/08 NEJM actually has a couple of articles relevant to TMS. The one you mentioned is very similar to the Jensen study on spinal MRI, which likely inspired its investigation. There was also another study that looked at the efficacy of knee surgery in patients with osteoarthritis and found no added benefit of surgery vs. medical/physical therapy alone. I suspect that many of these patients carrying the diagnosis of osteoarthritis of the knee probably just have TMS. Unfortunately, the study did not have a placebo group as well.
The article was:
A Randomized Trial of Arthroscopic Surgery for Osteoarthritis of the Knee
Alexandra Kirkley, M.D., Trevor B. Birmingham, Ph.D., Robert B. Litchfield, M.D., J. Robert Giffin, M.D., Kevin R. Willits, M.D., Cindy J. Wong, M.Sc., Brian G. Feagan, M.D., Allan Donner, Ph.D., Sharon H. Griffin, C.S.S., Linda M. D'Ascanio, B.Sc.N., Janet E. Pope, M.D., and Peter J. Fowler, M.D.
Conclusions Arthroscopic surgery for osteoarthritis of the knee provides no additional benefit to optimized physical and medical therapy.
This one (from 7/11/02), however, did have a placebo wing and proved (yet again) the boundless power of the human mind!
A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee
J. Bruce Moseley, M.D., Kimberly O'Malley, Ph.D., Nancy J. Petersen, Ph.D., Terri J. Menke, Ph.D., Baruch A. Brody, Ph.D., David H. Kuykendall, Ph.D., John C. Hollingsworth, Dr.P.H., Carol M. Ashton, M.D., M.P.H., and Nelda P. Wray, M.D., M.P.H.
Conclusions In this controlled trial involving patients with osteoarthritis of the knee, the outcomes after arthroscopic lavage or arthroscopic débridement were no better than those after a placebo procedure.
Best,
MK
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knee & hip pain
