Vitamin D and Muscle Pain
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Dr. Filice was on staff from 2003 until 2007
In a study just released (Mayo Clinic Proceedings December 2003; 78: 1463-1470, 140 out of 150 people with muscle pain seen at a university healthcare center had vitamin D deficiences (less than 20 ng/ml). The people came to the center with non-specific musculoskeletal pain. The authors believe that there is so much vitamin D deficiency because so little exists in the diet including fortified milk, and most people intentionally or unintentionally avoid sun exposure. This includes those who work long hours, eat lunch indoors and wear sun screen. However even with sun exposure, the capacity to generate adequate vitamin D is reduced by obesity, age, smoking status, clothing worn, latitude, winter season and amount of skin pigmentation. The darker one's skin, the more birthdays one has, and the further north one lives, the higher the risk for hypovitaminosis D.
The take home point folks is to chug that cod liver oil. There are few products as healthy as cod liver oil. Here let me go to my refrigerator. Ah, yes the cod liver oil I drink (available at www.benuts.com). One tablespoon of benuts cod liver oil has 430 iu's or 108% of the RDA. Plus once a week or so I take a 5,000 iu capsule of vitamin D. So those with muscle pain and who don't want to get osteoporosis considering taking some extra vitamin D. For those of you who take the full dose of Benuts Supervits you still need some extra vitamin D, so consider taking some cod liver oil, it comes in a tasty orange flavor. Cheers!
arthroscopic surgery
for arthritis sufferers
Bob Filice, M.D.
Several years ago (summer 2002) the Arthritis Foundation featured a story based on a VA study of 180 Veterans published in the New England Journal of Medicine about the value of arthroscopic surgery for arthritis sufferers. The study was rare and unique because it included a “sham surgery” group which had anesthesia and skin incisions but no introduction of the arthroscope into the knee. The other two groups consisted of one that had arthroscopic debridement (shaving down and removal of abnormal tissue or cartilage), and an arthroscopic lavage group (where debris and crystals in the joint were flushed out). All procedures were carried out by the same experienced surgeon. The results of the study support what we have contended at Caring Medical, and what prolotherapists have been trying to tell the medical community for years.
Arthroscopic surgery is an ineffective approach to the care of the arthritic knee.
The study found that the group that had the least SLOWING DOWN of their walking and stair climbing rate after 2 years was the placebo surgery group. All groups had modest decrease in reported pain and increase in range of motion, but the placebo surgery group were rated the best. In other words arthroscopic surgery in arthritis patients is less effective than placebo, and appears to actually worsen gait and performance on steps. Considering that over 300,000 of these procedures are done in the US annually at a cost of $15 billion, patients and insurers both should take heed of what the study is telling us. Surgical procedures are rarely studied under double blind placebo controlled conditions as in this study for ethical reasons (the general risks associated with even sham surgery), but two NIH commentators both agreed that the results of this study justified its performance. Some orthopedists have expressed the opinion that arthroscopic surgery should be reserved for acute athletic injuries.
The conclusions I would draw from this study are this: Never submit to an arthroscopic procedure if your problem is osteoarthritis. It may make you worse, and is no more effective than placebo surgery. Also, in my opinion, before considering arthroscopy or surgery on any joint for any reason, obtain a complete evaluation by a prolotherapist.
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