MCW HealthLink -- vol. 5 no. 8

[Guest guest]

======================================================================

MCW HealthLink

Medical College of Wisconsin

Milwaukee, Wisconsin

http://healthlink.mcw.edu/

======================================================================

15 April 2001

Vol. 5 No. 8

In this issue:

(1) Acupuncture Provides Pain Relief for Many Patients

(2) Plantar Fasciitis is a Common Cause of Heel Pain

(3) Vitamin A and Carotenoids

(4) What's New on MCW HealthLink

(5) Subscriber Information

----------------------------------------------------------------------

(1) Acupuncture Provides Pain Relief for Many Patients

----------------------------------------------------------------------

Acupuncture is an ancient practice in which very fine needles are

inserted into the skin at strategic points on the body to relieve

pain and treat disease. The Chinese developed acupuncture

centuries ago according to the theory that energy flows through

channels in the body between the surface of the body and internal

organs. When channels become blocked, needles placed at one end of

the channel can restore healthy energy.

Western medicine’s view is that the placement of acupuncture

needles at specific pain points releases endorphins and opioids,

the body’s natural painkillers. Cells associated with the immune

system as well as neurotransmitters and neurohormones in the brain

may also be released. Research has shown that glucose and other

bloodstream chemicals become elevated after acupuncture, according

to Lynn M. Rusy, MD, Associate Professor of Anesthesiology at the

Medical College of Wisconsin and a board-certified acupuncture

practitioner. She is also Associate Director of the Jane B. Pettit

Comprehensive Pain Management Center at Children’s Hospital of

Wisconsin.

Acupuncture needles are metallic and sterile, used once and

discarded. Needles are solid (not hollow, as are hypodermic or

vaccination needles) and are slightly bigger than the width of

human hair. Patients can feel the needle pierce the skin, but

there is no pain. When the needle locates the trigger point, there

may be a “grabbing” sensation, followed by a relaxed, heavy

feeling and overall body warmth.

There are several acupuncture methods beyond simply inserting

needles. Sometimes a low electrical charge is sent through the

needles or the needles may be heated by a heat lamp or a “moxa

stick”, which is an herbal heat source that looks and burns like a

cigar. Sometimes two needles are used at one trigger point. The

needles may also be twirled or manipulated by hand, and sometimes

needles aren’t used at all, but trigger points are massaged

instead.

According to a National Institutes of Health panel, clinical

studies have shown that acupuncture is helpful in treating nausea

caused by surgical anesthesia and cancer chemotherapy, dental pain

after surgery, addiction, headaches, menstrual cramps, tennis

elbow, fibromyalgia, myofascial (connective tissue) pain,

osteoarthritis, lower back pain, carpal tunnel syndrome, asthma

and to assist in stroke rehabilitation. The World Health

Organization lists more than 40 conditions for which acupuncture

may be used.

A standard acupuncture session by a physician trained in

acupuncture costs $50-70.

>> http://healthlink.mcw.edu/content/article/29499/987115954.html

----------------------------------------------------------------------

(2) Plantar Fasciitis is a Common Cause of Heel Pain

----------------------------------------------------------------------

Plantar fasciitis, which may cause the heel to hurt, feel hot or

swell, is inflammation of the plantar fascia, a thin layer of

tough tissue supporting the arch of the foot. Repeated microscopic

tears of the plantar fascia cause pain. Sometimes plantar

fasciitis is called “heel spurs”, but this is not always accurate,

since bony growths on the heel may or may not be a factor.

Typically with plantar fasciitis, the pain is worse when first

getting out of bed or at the beginning of an activity, and gets

better as the muscles warm up. Prolonged standing may cause pain,

as well. In severe cases, the pain may worsen toward the end of

the day.

There are a number of possible causes for plantar fasciitis and

they often work in combination. Tightness of the foot and calf,

improper athletic training, stress on the arch or weakness of the

foot are potential causes. Shoes that don’t fit, certain play or

work actions or over training may hurt the plantar fascia. People

with low arches, flat feet or high arches are at increased risk of

developing plantar fasciitis.

Symptoms usually resolve more quickly when the time between the

onset of symptoms and the beginning of treatment is as short as

possible. Unfortunately, the complete resolution of symptoms may

take 6-18 months. Treatment will typically begin by correcting

training errors, which usually requires some degree of rest, the

use of ice after activities, and an evaluation of the patient’s

shoes and activities. For pain, nonsteroidal anti-inflammatory

drugs (e.g. aspirin, ibuprofen) may be recommended.

Next, risk factors related to how the patient’s foot is formed and

how it moves are corrected with a stretching and strengthening

program. If there is still no improvement, night splints (which

immobilize the ankle during sleep) and orthotics (customized shoe

inserts) are considered. Approximately 80% of patients improved

after wearing a night splint. Cortisone injections, one of the

last resorts, have a success rate of 70% or better. The final

option, surgery, has a 70-90% success rate.

This information comes from an article co-authored by two Medical

College of Wisconsin faculty -- Drs. Craig C. Young, MD, and Mark

W. Niedfeldt, MD -- in the February 1, 2001, issue of American

Family Physician. Dr. Young, the lead author, is Associate

Professor of Orthopaedic Surgery as well as Medical Director of

the Froedtert & Medical College Sports Medicine Center. Dr.

Niedfeldt is Assistant Professor of Family & Community Medicine

and a physician at the Froedtert & Medical College Sports Medicine

Center.

>> http://healthlink.mcw.edu/content/article/29499/987116429.html

----------------------------------------------------------------------

(3) Vitamin A and Carotenoids

----------------------------------------------------------------------

Vitamin A is actually a family of vitamins, including retinol and

provitamin A carotenoids, such as beta-carotene, which the body

converts to vitamin A. Vitamin A plays an important role in

vision, bone growth, reproduction, and cell division and

differentiation, according to the National Institutes of Health.

Vitamin A maintains the surface linings of the eye and

respiratory, urinary and intestinal tracts. Vitamin A may also

help white blood cells fight infection. It may also help prevent

bacteria and viruses from entering the body by maintaining the

integrity of skin and mucous membranes.

Whole eggs, whole milk and liver are among the few foods that

naturally contain vitamin A. Many foods, such as fat-free milk and

breakfast cereals, are fortified with Vitamin A.

The Recommended Dietary Allowance is 1,000 international units for

men and 4,000 IU for women, including pregnant and breastfeeding

women. A safe upper limit from diet and supplements is 8,000-

10,000 IU per day. RDAs for children are: 2,000 IU for 1-3 year

olds, 2,500 IU for 4-6 year olds, and 3,500 IU for 7-10 year olds.

Surveys suggest that the diets of up to 25% of Americans do not

provide the recommended RDAs.

Three ounces of chicken liver, for example, contains 13,920 IU of

vitamin A, while one cup of fortified, fat-free milk contains 500

IU, and 1/8 of a 12-inch pizza contains about 380 IU. A raw

carrot, 7-8 inches long, contains 20,250 IU of vitamin A, while a

medium-sized peach contains 525 IU and a packet of fortified

instant oatmeal contains 1,050 IU.

Vitamin A deficiency is rare in the US, but affects more than 120

million children worldwide. It is a leading cause of childhood

blindness. Signs of vitamin A deficiency include night blindness,

dry skin, dry hair, broken fingernails and decreased resistance to

infections.

Some surveys have suggested that diets rich in beta-carotene and

vitamin A decrease the risk of certain types of cancer, while

others found an increased risk with beta-carotene. Beta-carotene

supplements are not recommended although they may have a role in

populations with vitamin A deficiencies. Too much vitamin A can be

toxic and may cause birth defects.

>> http://healthlink.mcw.edu/content/article/29499/980793489.html

----------------------------------------------------------------------

(4) What's New on MCW HealthLink

----------------------------------------------------------------------

* Easing Your Mind About Pain in the Face

In Tic douleureux, also called trigeminal neuralgia, the

trigeminal nerve is hypersentisitve, causing stabbing pain

on one side of the face.

http://healthlink.mcw.edu/content/article/29499/987116799.html

* Empty Calories in the School Cafeteria

A recent study showed that an extra soft drink per day gives

a child a 60% greater chance of becoming obese, regardless

of their diet and level of activity.

http://healthlink.mcw.edu/content/article/29499/987117027.html

----------------------------------------------------------------------

(5) Subscriber Information

----------------------------------------------------------------------

MCW HealthLink is published by the Medical College of Wisconsin,

Milwaukee, Wisconsin, as a service to our patients and the

community at large. Subscription is free of charge.

To inform your friends and relations about our website and

newsletter, please go to our 'Tell-a-Friend' page at

http://healthlink.mcw.edu/friend.html.

To cancel your subscription, Please go to:

http://healthlink.mcw.edu/content/unsubscribe_form.pl?29499:956025338

or send an e-mail to healthlink@... with UNSUBSCRIBE in the

message's subject line.

MCW HealthLink is provided for educational purposes. The

information is not intended as a substitute for medical care, or

for the advice of a physician. Please consult your doctor to

determine how the information here pertains to you.

----------------------------------------------------------------------

Medical College Physicians

9200 West Wisconsin Avenue, Milwaukee, WI 53226-3522 USA

HealthLink home page: http://healthlink.mcw.edu/

e-mail: mailto:healthlink@...

Physician directory: http://doctor.mcw.edu/

Appointments & information: (414) 805-3666 or

1-800-272-3666 toll-free

----------------------------------------------------------------------

Copyright © 2001, Medical College of Wisconsin.

ALL RIGHTS RESERVED.

=29499=956025338=