For some of us chronic pain determines how we sit, stand, walk, talk and think about life. Are you aware that it keeps you awake nights or makes you feel crabby, tired or discouraged? Is the pain general, localized, sharp, piercing, hot, or nagging? Is there stiffness, numbness, or loss of sensation? You may have learned to live with it so efficiently that you accommodate your work routine, personal habits, and love life to pain. It is neither a naughty child nor a bully chasing you.

How you experience pain is shaded by your conception of it: Do you consider its origin an injury, a physical deficiency, a trick of fate, or a character fault? What doctors, herbalists, chiropractors, homeopaths, massage professionals, and other healers may call your pain depends on their system of healing. Our natural approach begins with diagnosis–the definition of pain and how it is viewed and treated by health professionals. But do not be limited by their training. Use what best works for you and experiment. Our needs change in time, depending on many factors and new therapies are on the horizon.

This is a personal journey: I have walked through fields of flowers, over snow covered mountains, around the Potala palace, and through Chinatown for many years. I took physical and health risks. I traveled alone through impoverished Chinese countryside, where white rice and noodles were my food, where a hole in the ground was a toilet, where kids screamed to see my blonde hair. Herbal medicines, including acupuncture and herbs sold on Chinese street corners and prescribed in hospitals, saved lives and eased pain in miraculous ways. I arrived in Ladakh by plane one flight a day without radar if good weather. Civil war had forced monks and soldiers into blood conflict. I walked to the ancient monasteries despite martial law clearing the streets. I have enjoyed the best Thai and Hong Kong restaurants and eaten with my fingers in jungles huts. I have shared bread, tea, and prayers with Indian gurus and bought rejuvenating herbs in Delhi’s old market. I have traveled by third class Chinese train and Thai elephant. It was worth every ache and illness. I have spent the afternoon contemplating the Mexican sunshine on a Mayan ruin, while consorting naked with iguanas. World travel and survival in New York have filled my days with adventure.

I need to preserve flesh and bone to accomplish my work. Many audacious baby boomers, born in hard times, driven by optimism and a free spirit–have suffered illness, injuries, and backbreaking work routines. Their stories and advice are here. This Net series Flesh and Bone is an ongoing account of my personal health protocol. (Search this site for  “F&B” ) We will begin by considering various forms of diagnosis and healing techniques beginning with allopathic and physical medicines. Following articles will consider approaches used by homeopathic medicine, nutrition, and herbal medicine.

The Allopathic Medicine View
Hips and knee replacements are the 3rd and 4th most common surgeries in the USA today.

Osteoarthritis, the most common form of arthritis, affects most of the population over the age of 50. It is also termed degenerative joint disease because osteoarthritis involves the deterioration of the articular cartilage that lines the joints and related changes in adjacent bone and joint margins. The most frequent sites involved in osteoarthritis are the weight-bearing articulations of the spine, hips, and knees, and the small joints of the hands. Symptoms usually include stiffness upon awakening and joint pain or tenderness following usage.

Mother at 86 is recovering from a total hip replacement operation she had a year ago in Albuquerque. Prior to surgery her pain prevented her from getting out of bed. She knew surgery would be risky and recovery slower than usual because of her age and lowered immunity after having had cancer and chemo several times. Now she moves around her town house with ease but often uses a cane outdoors to keep people from bumping into her. She cooks family dinners and keeps herself and the house in perfect order. I love Hungarian known-how and old world spunk! When Mother and my younger sister, Michelle, followed the required routine of doctor visits to prepare for Mom’s surgery, they noticed that quite a few people in their 50s were in the surgeon’s office preparing for hip and knee surgery.

Some had been joggers; dancers, laborers and many were overweight people. The more extra weight you carry–the harder it is on your joints. Hips and knee replacements are among the most common surgeries in the USA now. Yearly, about 350,000 people get new hips and about 450,000 people get new knees. The medical diagnosis you are likely to get from your MD if you have chronic hip or knee pain in your 40s – 80s will depend on your level of pain and mobility. Few doctors with allopathic medical training recommend nutrition. Their recommendations depend most often of your X-rays or MRI tests to determine the extent of bone and joint damage. In other words they diagnose a disease “incurable except by surgery.”

More holistically inclined MDs may say, delay surgery until you can’t tolerate the pain because there are possible complications and dangers involved with surgery. We will cover them later.

The medical definition of arthritis is inflammation or inflammatory pain (its is often used to express inflammation) affecting the bones and joints often with stiffness and reduced mobility. There may or may not be difficulty walking or pain with standing up or sitting down. No indisputable cause is given for arthritis affecting hips, knees or other joints. Doctors say it may result from injury. It may be related to age, hormonal factors, posture, or maybe even heredity. Consider your family diet hereditary. If you and your family live on junk foods, smokes or drugs, you don’t have to look far to find malnutrition and resulting pain.

Dr. Sculco, MD, Surgeon in Chief at the Hospital for Special Surgery in New York, has said, “When arthritis gets into the bone there is little you can do but replace it.” Non-surgical methods Dr. Sculco recommends for reducing joint pain include:
•    Weight reduction
•    Exercise (“a stationary bicycle allows mobility and strength”)
•    Anti-inflammatory medications
•    Injections of hyaluronic acid (to help increase cartilage) or cortisone shots for reducing inflammatory pain

Medical View summary:

The medical view of arthritic back, hip and knee pain is based on trauma medicine: If it breaks, replace it. You might ameliorate pain temporarily with weight loss, pain drugs, and exercise. But eventually everyone needs surgery. Most doctors do not consider diet or emotional factors to be important for preventing pain or joint damage. At least it is not part of their training. They figure joints age and everyone has stress. With an aging population and improved surgery techniques their future is set. One limitation to their financial welfare is that an increasing number of people seek operations in other countries for a fraction of the American price. That, we will cover it later, can lead to medical complications, including the real possibility of infection.