Pain Doctor: No Need to Suffer. Pain Center of Orlando

Nutraceutical Intervention and Treatment of Prostate Cancer

Prostate cancer is a significant health issue. It is estimated that one in six American men will eventually be diagnosed with prostate cancer. Prostate cancer is the second leading cancer killer in men, trailing the death rate due to lung cancer. In total, more men will be diagnosed with prostate cancer than women will be diagnosed with breast cancer.  Resulting in large part from hormonal imbalance, prostate cancer in large part a preventable disease state.

 

The incidence of microscopic prostate cancer is around 80% in men between the ages 70 and 80 years old, 40% in men between 50 and 60 years of age, and around 34% in men between 40 and 50 years old. Microscopic prostate cancer is present in around  25% in men between 30 and 40 years old.

 

Estrogen

 

After the age of 21, estrogen levels in women decrease with time. In men, however, estrogen levels will increase with age. At the age of 40 years, total estrogen levels in an average male equals or exceeds the female of the same age, and with increasing age, male estrogen levels will significantly exceed those in found in females.  These increased estrogen levels cause many of the age-related medical complaints in men: erectile dysfunction, prostatic enlargement, hair loss, depression and weight gain. 

 

Testosterone

            Testosterone levels peak, in both men and women, and testosterone levels decrease, linearly, with age.  Testosterone levels will decrease by approximately 2% per year between the ages of 25 and 50. 

 

DHEA

            Dihydroepinandosterone (DHEA) is the most prevalent hormone in human physiology. DHEA is a precursor to progesterone, testosterone, androstendiol, and estradiol.  DHEA levels decrease predictably with age, and with decreasing DHEA levels, testosterone levels tend to drop, as well.  Low levels of DHEA has been identified as factor in depressive illness, low levels result in loss of libido in men and women, and low levels of this  hormone are related to the development of dementia. 

 

The Ratio Effect

 

            Steroidal hormones act to trigger genetic switches in cell nuclei.  The effector sites at the cell nucleus most often involve multiple hormones, some stimulatory, some inhibitory.  The ratio of these hormones, relative to each other, triggers cellular events.  That is, the ratio of testosterone to estrogen, or estrogen to progesterone determines cellular effect.  It is for this reason that the ‘level’ of the hormone is only significant <span>in relation to the other hormones</span> that effect the same genetic trigger. In short, it is the testosterone to estrogen ratio that will indicate the state of balance.  Other hormones, such as pregnenolone, androstendione, thyroxin, and cortisol are important, and attention to these is important, as well.

 

 

Useful Non-prescription Intervention

• Curcumin – 500 to 750  mg twice, daily. Curcumin is a yellow pigment in Turmeric (Curcuma longa).   
• Genistein - 200 mg daily. An isoflavone that inhibits the growth of cancer cells and acts as an antioxidant. Genistein, however, is an inhibitor of thyroid function, and its use is best avoided.
• Green tea extract (GTE)- Rich in l-theanine and ECGC,  cancer cell growth is inhibited and GTE induces apoptosis (programmed cell death).
• Lycopene - 10 mg daily. A carotenoid found primarily in tomatoes.
• Melatonin – 10-20 mg daily. Enhances immune function, inhibits cancer cell growth and potentiates the beneficial effects of chemotherapy/ radiation while reducing their side effects.
• Selenium - 400–800 mcg daily. Antioxidant.
• Vitamin D-3 (cholecalciferol)-  Selective estrogen receptor blocker.  Reduces the risk of prostate cancer by 50% when taken in minimum dosage of 2,000 IU daily.  Must be taken simultaneously with an oil capsule, as Vitamin D-3 is lipid soluble. Cholecalciferol inhibits cancer cell growth and may induce apoptosis.
• Vitamin E (mixed tocopherols) - 800 IUs daily will inhibit cancer cell growth and promotes normal cell division. Dosages above 800 IU/daily may be associated with increase risk of hip fracture.
• Zinc chelate – 15 to 50 mg daily. Zinc should be taken carefully, as overuse can be toxic.  Copper must be taken concurrently with zinc, in a 30-40:1 ratio.
• Indole-3-carbinol
• Saw Palmetto Extract - Testosterone levels can be increased with the proper use of Saw Palmetto (Serenoa repens) - Inhibits 5-alpha reductase (converts testosterone [T] to dihydrotestosterone [DHT], an androgen 5 times more potent than [T], and this drives the growth of prostate cancer cells).
• D-glucaric Acid – Removes excessive estrogen due to inhibition of beta-glucoronidase activity. Estrogen esters remain bound for biliary excretion, and the total estrogen load on the body is reduced.  
• Silymarin – Increases excretion of estrogen esters through the biliary system and it may inhibit beta-glucuronidase, thereby limiting the enterohepatic recycling of hormones like estrogen. Silymarin inhibits the peroxidation of lipids within the hepatic cell and decreases the synthesis of cholesterol by the liver. Silymarin suppresses tumor necrosis factor (TNF)-activation of certain nuclear transcription factors and induces various cyclin-dependent protein kinase inhibitors, thereby acting to inhibit cellular inflammation and inhibit carcinogenesis.

 

David S. Klein, MD, FACA, FACPM

Selenium Supplement Intake and Prostate Cancer Prevention

Introduction

Prostate cancer presents a very real risk to life and longevity. The incidence of prostate cancer rises dramatically with age. Genetic predisposition does play a role in the risk of prostate cancer, but it is difficult to change the structure and nature of the gene thereby mitigating cancer risk. It is, however, fairly easy to alter some environmental risk factors that dramatically improve risks for disease development.

Evidence suggests a significant link between prostate enlargement (BPH) and hormonal levels. As males age, production of androgenic (male) hormones decreases, causing an imbalance in androgen and estrogen levels, and high levels of dihydrotestosterone (DHT), the main prostatic intracellular androgen.

The likelihood of developing an enlarged prostate increases with age.Prostate enlargement is present in many males older than age 40, and prostate enlargement is present in more than 90% of males older than the age of 80.

Blacks have a higher incidence of prostate cancer, with an incidence rate of 224.3 cases per 100,000 people, and blacks are at the greatest risk to present with more advanced neoplastic disease associated with a poorer diagnosis. Whites, by comparison, have an incidence of 150.3 cases per 100,000 people, and Asians have an incidence of 82.2 cases per 100,000 people.

Supplement Selection

Selenium: At least five major clinical trials have concluded that higher levels of selenium (in blood or toenail clippings) are associated with a sharply reduced risk of prostate cancer. The Nutritional Prevention of Cancer (NPC) trial found that supplementing with 200 micrograms/day of selenium cuts prostate cancer risk in half. Researchers at the Harvard Medical School now weigh in with another study confirming the beneficial effects of selenium. Their study involved 22,000 healthy, male physicians who were enrolled in the study in 1982 and had blood samples taken at that time. Sufficient samples to analyze for selenium content and PSA level were available for 586 men diagnosed with prostate cancer as well as for 577 controls matched for age and smoking status. After 13 years of follow-up the researchers concluded that study participants with a plasma selenium level of 0.12-0.19 ppm had a 50% lower incidence of advanced prostate cancer than did men with a level of 0.06-0.09 ppm. The correlation was only apparent in men with a PSA level of more than 4 ng/mL and was particularly strong for those with a baseline (1982) PSA level greater than 10 ng/mL. For these men a high selenium level corresponded to a 70% decrease in the risk of advanced prostate cancer. The researchers also observed a trend for a lower incidence of localized prostate cancer with high selenium levels, but this trend was not statistically significant. They conclude that selenium is perhaps not too effective in preventing the initiation of prostate cancer, but that it is highly effective in slowing down tumor progression. They believe that selenium acts by selectively killing off cells whose DNA has been extensively damaged, by inhibiting cellular proliferation, and by its role as a key component of glutathione peroxidase, which protects cells from peroxide damage.

Spinal Withdrawal Reflex and Athletic Performance. Improvement with Kink Ease.

The Spinal Withdrawal Reflex and Athletic Performance

While the principal focus of athletic training has been placed, traditionally, on improvement in strength and enhanced flexibility, measurable degradation in actual performance results from involuntary, protective mechanisms ‘hard-wired’ into our nervous system.

The Spinal Withdrawal Reflex (SWR) is one such protective mechanism that robs the athlete of what could be the winning difference or competitive edge.

Sometimes known as the nociceptive spinal reflex, the SWR protects the body from self inflicted damage. Stretch, pressure, or pain receptors are triggered, and a signal follows the sensory nervous system to the spinal cord. Processed in the Dorsal Horn, a reflex signal is then sent back to the same limb or region of the body accomplishing a ‘shut down’ of the offending muscle or muscle groups.

One example might be a tear in the rotator cuff of the shoulder. As the athlete reaches with the arm, a pain signal from the damaged shoulder ligament travels to the spinal cord causing a reflex ‘withdrawal’ of the shoulder muscles. Because of the SWR, and due to the protective nature of the reflex, the shoulder muscles are never allowed by this body to operate at full capacity,. The net effect is decreased range of motion and a measurable decrease in strength. This decrease is estimated to be between 1-4% of optimum performance.

Important to the athlete is that the decrease in range of motion, strength and flexibility can be reduced or eliminated by decreasing the pain modulator in the damaged tissue. That is, modulating the pain receptor can measurably and significantly improve performance and recovery. This must be accomplished without increasing the likelihood of re-injury. Medicines that ‘numb’ the pain receptor increase the likelihood of re-injury by reducing the pain signals that result from tissue damage. Local anesthetics and counter-stimulants fall into this category.

While it is critical for full recovery, to insure that the injury has proper time to heal, it is also vitally important that the rehabilitation process allows for full extension and performance of the injured area. Too many times the physical therapy recovery is inhibited by the discomfort of the person going through their exercises. We must make certain that the individuals in recovery are “pushed” to their safe limits in order to guarantee they return at optimum effectiveness. Ironically, the more strenuous the safe management of the recovery process, the quicker we can usually expect a return to activity. This time factor can be critical regardless of whether you run a dojo or are competing.

The pain receptor can, however, be safely modulated with resulting improvement in strength and flexibility using anti-inflammatory and anti-oxidant topical medications such as a high-concentration methylsulfonylmethane (MSM) containing salve.


In summary, the performance-robbing qualities of the spinal withdrawal reflex can be reduced, with high concentration transdermal MSM, thereby improving flexibility, range of motion and muscular strength. Improvement by as little as 2-5% in strength, reach and range of motion could make the difference between winning and losing. It has been said that at the professional level in most sports the difference between winning and losing is usually around a 1% difference in performance. Low concentration MSM containing salves, such as Tiger Balm® are somewhat beneficial where newer products that contain high concentrations of MSM, such as Kink Ease® provide much more rapid and dramatic results.


(If you have any questions about this article, the use and characteristics of MSM or any other issues please contact Dr. Klein. He can be reached @ [email protected] or visit his web site for related articles: http://www.suffernomore.com )

Curcumin is a potent anti-oxidant. Useful for protection of cardio vascular system.

J Cardiovasc Pharmacol. 2007 Jul;50(1):41-9.

Curcumin attenuates inflammatory responses of TNF-alpha-stimulated human endothelial cells.

Kim YS, Ahn Y, Hong MH, Joo SY, Kim KH, Sohn IS, Park HW, Hong YJ, Kim JH, Kim W, Jeong MH, Cho JG, Park JC, Kang JC.

Heart Center of Chonnam National University Hospital, Gwangju, South Korea.

Curcumin, a yellow pigment of turmeric in curry, is reported to interfere with nuclear factor (NF)-kappaB. This study was designed to investigate the underlying pathway of antiinflammation of curcumin on endothelial cells. Human umbilical vein endothelial cells (HUVECs) were stimulated with 10 ng/mL tumor necrosis factor (TNF)-alpha. Curcumin blocked the activation of NF-kappaB by TNF-alpha. Curcumin also reduced the intracellular reactive oxygen species (ROS), monocyte adhesion, phosphorylation of c-Jun N-terminal kinase (JNK), p38, and signal transducer and activator of transcription (STAT)-3 in TNF-alpha-stimulated HUVECs. The expression of intracellular cell adhesion molecule (ICAM)-1, monocyte chemoattractant protein (MCP)-1, and interleukin (IL)-8 were attenuated by curcumin at both mRNA and protein level. Curcumin, however, did not affect the expression of TNF receptor I and II in TNF-alpha-stimulated HUVECs. We suggest that curcumin could contribute to protection against the adverse vascular effect of the proinflammatory response through the modulation of p38 and STAT-3 in addition to NF-kappaB and JNK in endothelial cells.

Updated Articles List

Brief articles on matters of general interest.  https://www.stages-of-life.com/healtharticles.aspx

Spider Veins, Varicose Vein and Hemorrhoid Alternative Treatments

David S. Klein, MD

Pain Center of Orlando, Inc.
225 W. SR 434 Suite #205
Longwood, Florida  32750

407-679-3337
www.suffernomore.com

Natural Treatment Options for Varicose Veins, Spider Veins and Hemorrhoids

Definitions:  Varicose veins are tortuous, swollen, enlarged veins. While any vein may become varicose, the veins most likely to become varicose are found in the legs, ankles and feet. Resulting from standing and walking upright, the  increase in venous back-pressure results in distension of the veins in the lower body.

Spider veins are a common, mild variation of varicose veins, involving superficial, smaller venous structures, close to the surface of the skin.

Treatment Options:

Horse chestnut extract (Aesculus hippocastanum) is one of the most widely used natural treatments for varicose veins. The active chemical moiety in horse chestnut is called aescin. Aescin blocks the release of enzymes that damage capillary walls.

Whole horse chestnut, that is, unprocessed, raw horse chestnut, is considered unsafe by the FDA. Use of the raw product may cause nausea, vomiting, diarrhea, headache, convulsions, circulatory and respiratory failure, and  death. Any use of the crude, raw product should be avoided. Extraction of Aescin from horse chestnut products removes the toxic component, esculin.

Patients that suffer with kidney or liver disease, bleeding disorders should use horse chestnut only after consulting a physician.  Horse chestnut should not be combined with aspirin, Plavix, Ticlid, Trental, Coumadin, and other blood-thinning drugs unless under medical supervision.

Butcher's broom (Ruscus aculeatus) is also known as box holly or knee holly. The active moieties,  ruscogenins, strengthen collagen in blood vessel walls and improve circulation, by tightening weak, stretched vessels such as those associated with varicose veins.

Side effects of butcher's broom may include indigestion or nausea. Patients with high blood pressure or prostate issues should not take butcher's broom without first consulting a doctor.

Vitamin K2 has been shown to activate the proteins that support the normal smooth muscle cells of the vein wall, and regular use of vitamin K2 may retard formation of varicose veins.

Copper deficiencies can lead to the development of varicose veins, spider veins, hemorrhoids and aneurysm.  While taking chelated copper may not reverse damage that is already done, it may behelpful to slow or stop the progression or worsening of the condition.

NOTE WELL:  Copper chelates must be used with caution, as effective dosages are quite modest and excess use can cause serious medical complications. Qualified medical supervision is essential before considering adding copper chelate to self-medication regiments.

David S. Klein, MD, FACA, FACPM

     

Cinnamon & Honey

David S. Klein, MD
Pain Center of Orlando, Inc.
225 W. SR 434 Suite #205
Longwood, Florida  32750

407-679-3337
www.suffernomore.com

Cinnamon and Honey

                                 David S. Klein, MD, FACA, FACPM

Okay, you saw this one several weeks ago, but, we are seeing a tremendous number of patients in the office with the flu and/or some miserable respiratory problem lasting up to 2 weeks or more. 

Look this over, and please........... buy some quality honey and cinnamon and give this remedy a try.  

Facts on Honey and Cinnamon: It is found that a mixture of honey and
Cinnamon cures most diseases. Honey is produced in most of the countries of the world. Scientists of today also accept honey as a 'Ram Ban' (very effective) medicine or all kinds of diseases. Honey can be used without any side effects for any kind of diseases.

Today's science says that even though honey is sweet, if taken in the right dosage as a medicine, it does not harm diabetic patients. Weekly World News, a magazine in Canada , in its issue dated 17 January,1995 has given the following list of diseases that can be cured by honey and cinnamon as researched by western scientists:

HEART DISEASES:

Make a paste of honey and cinnamon powder, apply on bread, instead of jelly and jam, and eat it regularly for breakfast. It reduces the cholesterol in the arteries and saves the patient from heart attack. Also those who have already had an attack, if they do this process daily, they are kept miles away from the next attack. Regular use of the above process relieves loss of breath and strengthens the heart beat. In America and Canada, various nursing homes have treated patients successfully and have found that as you age, the arteries and veins lose their flexibility and get clogged; honey and cinnamon revitalize the arteries and veins.

ARTHRITIS:

Arthritis patients may take daily, morning, and night, one cup of hot water With two spoons of honey and one small teaspoon of cinnamon powder. If Taken regularly even chronic arthritis can be cured. In a recent research Conducted at the Copenhagen University, it was found that when the doctors Treated their patients with a mixture of one tablespoon Honey and half Teaspoon Cinnamon powder before breakfast, they found that within a week, Out of the 200 people so treated, practically 73 patients were totally Relieved of pain, and within a month, mostly all the patients who could not Walk or move around because of arthritis started walking without pain.

BLADDER INFECTIONS:

Take two tablespoons of cinnamon powder and one teaspoon of honey in a Glass of lukewarm water and drink it. It destroys the germs in the bladder.

CHOLESTEROL:

Two tablespoons of honey and three teaspoons of Cinnamon Powder mixed in 16 ounces of tea water, given to a cholesterol patient, was found to reduce The level of cholesterol in the blood by 10 percent within two hours. As Mentioned for arthritic patients, if taken three times a day, any chronic Cholesterol is cured. According to information received in the said Journal, pure honey taken with food daily relieves complaints of cholesterol.

COLDS:

Those suffering from common or severe colds should take one tablespoon Lukewarm honey with 1/4 spoon cinnamon powder daily for three days. This Process will cure most chronic cough, cold, and clear the sinuses.

UPSET STOMACH:

Honey taken with cinnamon powder cures stomach ache and also clears Stomach ulcers from the root.

GAS:

According to the studies done in India and Japan , it is revealed that if Honey is taken with cinnamon powder the stomach is relieved of gas.

IMMUNE SYSTEM:

Daily use of honey and cinnamon powder strengthens the immune system and Protects the body from bacteria and viral attacks. Scientists have found That honey has various vitamins and iron in large amounts. Constant use of honey strengthens the white blood corpuscles to fight bacteria and viral Diseases.

INDIGESTION:

Cinnamon powder sprinkled on two tablespoons of honey taken before food Relieves acidity and digests the heaviest of meals.

INFLUENZA:

A scientist in Spain has proved that honey contains a natural ' Ingredient' Which kills the influenza germs and saves the patient from flu.

LONGEVITY:

Tea made with honey and cinnamon powder, when taken regularly, arrests the Ravages of old age. Take four spoons of honey, one spoon of cinnamon powder And three cups of water and boil to make like tea. Drink 1/4 cup, three to Four times a day. It keeps the skin fresh and soft and arrests old age. Life spans also increases and even a 100 year old, starts performing the Chores of a 20-year-old.

PIMPLES:

Three tablespoons of honey and one teaspoon of cinnamon powder paste. Apply this paste on the pimples before sleeping and wash it next morning with Warm water. If done daily for two weeks, it removes pimples from the root.

SKIN INFECTIONS:

Applying honey and cinnamon powder in equal parts on the affected parts Cures eczema, ringworm and all types of skin infections.

WEIGHT LOSS:

Daily in the morning one half hour before breakfast on an empty stomach And at night before sleeping, drink honey and cinnamon powder boiled in one Cup of water. If taken regularly, it reduces the weight of even the most obese person. Also, drinking this mixture regularly does not allow the fat to accumulate in the body even though the person may eat a high calorie diet.

CANCER:

Recent research in Japan and Australia has revealed that advanced cancer of the stomach and bones have been cured successfully. Patients suffering from these kinds of cancer should daily take one tablespoon of honey with one teaspoon of cinnamon powder for one month three time s a day.

FATIGUE:

Recent studies have shown that the sugar content of honey is more helpful rather than being detrimental to the strength of the body. Senior citizens, who take honey and cinnamon powder in equal parts, are more alert and flexible. Dr. Milton, who has done research, says that a half Tablespoon of honey taken in a glass of water and sprinkled with cinnamon powder, taken daily after brushing and in the afternoon at about 3:00 P.M. When the vitality of the body starts to decrease, increases the vitality of the body within a week.

BAD BREATH:

People of South America , first thing in the morning, gargle with one teaspoon of honey and cinnamon powder mixed in hot water, so their breath stays fresh throughout the day.

HEARING LOSS:

Daily morning and night honey and cinnamon powder, taken in equal parts restore hearing. Remember when we were kids? We had toast with real butter and cinnamon sprinkled on it!

Vitamin D-3 in the Prevention & Treatment of Viral Infections and Influenza

Vitamin D-3 in the Prevention & Treatment of Viral Infections and Influenza

Author: David S. Klein, MD

Date: September 23, 2009

David S. Klein, MD, FACA, FACPM
Stages of Life, Inc.

Pain Center of Orlando, Inc.
225 W. SR 434, Suite #205
Longwood, Florida  32750

407-679-3337

www.suffernomore.com
www.stages-of-life.com

Vitamin D-3 in the Prevention & Treatment of Viral Infections and Influenza

Supplemental cholecalciferol (vitamin D) significantly reduces all-cause mortality emphasizes the medical, ethical, and legal implications of promptly diagnosing and adequately treating vitamin D deficiency. Vitamin D deficiency is common, and is implicated in most of the diseases of civilization.

    Vitamin D-3 is a steroidal hormone that targets more than 200 human genes in a wide variety of tissues. With genes asits target, vitamin D has been shown to up-regulate the gene that is in volved in the production of cathelicidin, a naturally occurring broad-spectrum antibiotic.

Treatment of vitamin D deficiency, in otherwise healthy persons involves dosages between 2,000-7,000 IU vitamin D-3, daily.  With serious systemic illnesses, associated with vitamin D deficiency, such as cancer, heart disease, multiple sclerosis, diabetes, autism, the doses should be somewhat higher to maintain 25(OH)D levels between 55 -70 ng per mL.

Vitamin D-deficient patients with serious illness should not only be supplemented more aggressively than the well, they should have more frequent monitoring of serum 25(OH)D and serum calcium.

NOTE: Doses of vitamin D-3 (2,000 IU per kg per day for three days) may produce enough of the naturally occurring antibiotic cathelicidin to cure common viral respiratory infections, such as influenza and the common cold, but such a theory awaits further science. This is a very high dosage regimen.  For general use, Vitamin D-3 dosages of 2,000 to 5,000 IU are sufficient to enhance immune function and minimize flu symptoms, if exposed to the virus.

Vitamin D-3 is very inexpensive, about $4 per month.  Because Vitamin D-3 is oil-soluble, it must be taken with an oil capsule, of almost any type.

David S. Klein, MD, FACA, FACPM is the Medical Director of the Pain Center of Orlando, Inc.  A graduate of the University of Maryland School of Medicine, Dr. Klein received training in General Surgery at the

University

of

North Carolina

, and Anesthesiology at

Duke

University

. 

Dr. Klein has been in private practice for 25 years and is a well published author, lecturing regionally and nationally on topics ranging from nutritional intervention, hormone replacement and pain treatment. 

                 

Muscle Tension Headache

Muscle tension headaches
David Klein, MD, FACA, FACPM

Headache is one of the most prevalent of all complaints that might bring a patient to seek medical attention.

Diagnostic evaluation of the patient may be simple or comprehensive, dictated by the situation and presentation.

Statistically, the most common cause of headache is muscle tension.

While the diagnosis of muscle tension headache (MTH) might suffice for most circumstances, unless the clinician locates the precise physical site of the ‘pain generator,’ the chances of successful treatment are slim. On the other hand, treatment is likely to be successful, if diagnosis is refined from the generic ‘muscle tension headache,’ to the more specific diagnosis.

The most common cause of MTH results from inflammatory changes at the site of muscular attachment on the occipital ridge. As inflammation develops, entrapment and irritation of greater occipital nerve results. The typical symptom complex results from muscle spasm as well as from neuralgia.

Occipital neuralgia results in a distinct type of pain that is most commonly characterized by piercing, throbbing, or lancinating pain in the upper neck, back of the head, and behind the eyes. Most commonly the problem is unilateral and because pain in the eye is typical, the misdiagnosis of ‘migraine’ is made. The pain of Splenius Capitis Syndrome (SCS) begins in the neck and then spreads to pain behind the eye.

The pain is caused by inflammation, irritation, or injury to nerves. Muscular spasm results in a second pain constellation.

Interestingly, the pain of muscle spasm and the pain that results from the neuralgia need not occur simultaneously and the nature of the pain will, therefore, change from episode to episode, adding to clinical confusion.

Causes include trauma to the back of the head, pinching of the nerves by overly tight neck muscles, and compression of the nerve as it leaves the spine due to osteoarthritis. Localized inflammation or infection can result in SCS, although this is quite rare. It can be caused by diabetes and blood vessel inflammation. Clearly, the most frequent cause is prolonged periods of keeping the head in a downward, rotated and forward position. The muscle tension results in micro trauma to the muscular attachment, swelling ensues, and myalgia/neuralgia result.

Symptoms: Occipital and shoulder pain; Pain behind the eyes; Awaken with pain; Pain looking up or down particularly with rotation; Worse with menses, ovulation, and salt load, Anticipate sleep disorder.

Causes of SCS: Trauma of a rotational nature; Blunt trauma, pugilism; Flexion/extension injury; Vigorous cervical manipulation Surgery; Dental chair; Mastoid surgery.

The causes of SCS can be quite distant from the site of pain.
That is, postural problems can result from foot pathology, ankle, knee and hip problems that result in muscular dystony. Physical problems in the lower extremity can cause physical changes in the axial skeleton. Postural pathology can result from an arthritic toe or heel spur, resulting in contralateral hip pain, and samesided headache.

Injection is performed in a short series, that is, once or twice, with pain relief lasting from a few weeks to many months.Skillful injection technique results in the most satisfactory results, and concurrent use of common anti-inflammatories speed recovery, particularly when combined with a low-dose diuretic. Muscle relaxant or anti-convulsants, dosed at bedtime provide relief of the neuralgia and side effects are minimized by the bedtime administration.

If exacerbation of pain is triggered by ovulation or dietary salt-load, routine, or periodic administration of a mild diuretic is worthwhile.

Dr. David S. Klein is the medical director of the Pain Center of Orlando, Inc. A graduate of the University of Maryland School of Medicine, Dr. Klein received training in general surgery at the University of North Carolina, and anesthesiology residency at Duke University.

Human Growth Hormone

In response to a posted question:

Human Growth Hormone (HGH) is rather controversial for a number of reasons. The body sees HGH during certain times of growth and maturation and it seems smaller levels during REM sleep.

There are persons who sue HGH to enhance muscle mass and in 'anti-aging' endeavors.

In some venues, HGH is currently being used to increase muscle tone, and this is dangerous on many levels. In particular, the effects on the heart are worrisome and will likely be found to shorten life-span. We see 'unexplained deaths' in highly successful athletes and it is highly possible that HGH is contributory to early cardiac death.

The effect on bone growth can cause cosmetic problems, as well. Enlargement of the frontal bones in the face cause a characteristic facial appearance in persons who use HGH.

There are other ways to deal with anti-aging. Hormone balance should be directed at restoring levels and ratios that are found at early adulthood ranges. By emulating hormone states that are normal at earlier ages is far better strategy than to try to improve on nature.

Pushing for levels that are outside of those that are found in nature can be dangerous business, indeed.