BLOG

To learn more about how we can offer comfort and well-being, follow our blogs. 

 

DISCLAIMER: Like all medical procedures, all the procedures that we perform have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else. 

Tuesday, September 04, 2018
By Edward Dieguez Jr. MD PA
Pin It

History of Acupuncture. 

Acupuncture is a very ancient form of healing that predates recorded history. The origin of Chinese medicine is a fascinating story and acupuncture represents only one facet of their medical system. The first recorded attempt at conceptualizing and treating disease dates back to about 1500 BC during the Shang dynasty. The philosophy behind acupuncture is rooted in the Daoist tradition which goes back over 8000 years. It is an ancient Chinese system of medicine which involves the practice of inserting fine needles into the skin.

 

World Health Organization and Acupuncture. 

Several years ago, the World Health Organization (WHO) published an official report listing 31 symptoms, conditions and diseases that have been shown in controlled trials to be treated effectively by Acupuncture. Following is the list of conditions shown through controlled trials to be treated effectively by Acupuncture:

  •   Low back pain
  •   Neck pain
  •   Sciatica
  •   Tennis elbow
  •   Knee pain
  •   Peri-arthritis of the shoulder
  •   Sprains
  •   Facial pain
  •   TMJ
  •   Headache
  •   Dental pain
  •   Acute and chronic gastritis
  •   Rheumatoid arthritis
  •   Induction of labor
  •   Breech birth presentation
  •   Morning sickness
  •   Nausea and vomiting
  •   Postoperative pain
  •   Stroke
  •   Essential hypertension
  •   Primary hypotension
  •   Renal colic
  •   Leucopenia
  •   Radiation/chemo reactions
  •   Allergic rhinitis,
  •   Hay fever
  •   Biliary colic
  •   Depression
  •   Acute bacillary dysentery
  •   Primary dysmenorrhea
  •   Acute epigastralgia
  •   Peptic ulcer

 

 

This landmark report, Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials, is available on the WHO website for download as a printable PDF file:

SOURCE: Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials, World Health Organization, 2003

 

It could help patients deal with insurance carriers who deny coverage for Acupuncture treatments for the situations contained in the report, especially those proven effective in controlled trials. WHO’s authority concerning health-related matters internationally cannot be challenged. If a patient’s treatment is on the lists of symptoms, syndromes, disease processes, pathologies, traumas and conditions that have been proven to be effectively treated by Acupuncture, the report should be presented to insurance carriers along with a request to reconsider coverage.

 

Acupuncture Schools in Florida.

The oldest and most prestigious school of Traditional Chinese Medicine in Florida is the Atlantic Institute Of Oriental Medicine (ATOM) located in Fort Lauderdale Florida. The University of Miami School of Medicine, and more specifically the Department of Complementary Medicine teamed up with ATOM Vice President,  Professor Fu Di PhD, for him to organize and teach both a basic and an advance course of Medical Acupuncture at the University of Miami for physicians. Both courses lasted 12 month. I was fortunate enough to attend both courses imparted by Professor Fu Di PhD, become friends with him and receive a wonderful letter from him.

 

How does Acupuncture works?

According to the traditional Chinese teachings, the theory behind acupuncture is based on the free and uninterrupted flow of a basic energy call “ qi “ (basic Life energy) thru the meridians of the body. Decease is caused by the disruption of the flow of this basic energy thru the meridians. There are 12 major or primary meridians, 8 extraordinary vessels and 12 divergent meridians. 

 Stimulation of certain points on these meridians to maintain the flow of “qi” or basic life energy flow to maintain health,  can be carried out by a variety of methods such as acupuncture needles, electro-acupuncture, laser, moxibustion sticks and cupping. One specialized modality of acupuncture also offered at our office is Auricular Acupuncture.

 

Why use acupuncture? 

Modern western medical theory cannot be ignored but combining it with traditional Chinese medicine (TCM) may have added benefits. Acupuncture can complementmodern western medicine to restore your health and boost your immunity and general well being. Given the safety of acupuncture compared with nearly all other medical interventions, it is reasonable to provide patients with an alternative such as acupuncture if current therapeutic options are not working, are expensive,  or are more dangerous. Today, after more than twenty years of clinical usage, the UCLA Center continues to use acupuncture as one of its main modalities for the relief of ailments.  For the last ten years since completing two full semesters of basic and advanced Acupuncture for Physicians at the University of Miami School of Medicine in 2008, Dr. Dieguez has been offering this alternative to patients interested in it. Besides being safe, many conditions can be treated. Try it today and see for yourself!

 

How we do it at our office.

We offer several acupuncture packages at a discounted rate, which we will discuss with you after your initial acupuncture mapping. First an initial medical evaluation will be schedule to better establish your condition. This evaluation, is covered by most insurance companies.  

We will then schedule your Computerized Meridian Maping to determine what acupuncture point need to be stimulated. At this time we will recommend to you how many acupuncture session will be needed and will present to you the discounted packages. Most condition will require three to four acupuncture sessions but at times six to eight may be in order. Some condition after getting them under control will require a maintenance session from time to time.  

 

 
Friday, August 17, 2018
By Edward Dieguez Jr. MD PA
Pin It

Facts About Knee Replacement that you should know about Before Surgery!

Most patient view surgery as getting a part fixed or replaced in their car. A parts wears out, so you replaced it or "fix it" with a new one. I prefer to look at it like this:  Surgery is damage to accomplish a goal and that goal is not always accomplished!  But the damage always is! Lets take this surgical damage concept to the knee. Here attached at the bottom are some pictures of the damage caused during a knee replacement surgical procedure. Piece of cake!! Don't you think? A lot of cutting, stretching and destruction! 

 

1.- Pain after knee replacement surgery. 

Persistent post surgical pain is a prevalent but under acknowledged condition after total knee replacement. Three to four years after knee replacement surgery 44% of patients still experience significant pain. In fact 15% report severe-extreme persistent pain. (Ref: https://ncbi.nlm.nih.gov/pubmed/21239114)

 

2.- Knee replacement surgery is many times unnecessary. 

In a new study releaased in the Arthritis and Rheumatology Journal, the findings are alarming since it found that only 44% of the total knee replacements done in the US where judged to be appropriate. In 27.1% of the knee replacements done in the US the evidence was inconclusive. And what is worse, in 34.3% the surgery was judged as totally inappropriate. (Ref:http://onlinelibrary.wiley.com/doi/10.1002/art.38685/abstract) 

 

3.- Recovery from knee replacement surgery can take over six months and at times it can take up to a year. 

Most surgeons, so as not to discourage you from having knee replacement surgery, will tell you that you will be well and running around in no time. They use terms like "a few weeks". Ask your surgeon to define the word "few". According to Brian Hatten MD who wrote "Road to Recovery" What to expect after knee replacement surgery, it is not that simple. It for sure does not sound like a piece of cake to me. Just read the guide. Here is the link to it. (Ref: https://www.mykneeguide.com/post-op/road-to-recovery) .

 

4.- Cost of knee replacement surgery. 

Add them up yourself. Six to twelve weeks before you can return to work. If you have a deductible in your insurance policy, it can go anywhere from a couple hundred dollars up to three or five thousand dollars and often more. Add to that any copays for doctors visit, medication costs, plus physical therapy deductibles, plus transportation cost you may have for a while since you won't be driving for four to six weeks, etc. etc. All of these can add up to a good pile of money. In addition if your insurance policy covers only 80% of the surgery and hospital stay, you would be in for a big surprise since the average cost of knee replacement surgery is around forty nine thousand dollars! So your 20% responsibility would be $9900.00 Not a piece a cake by any means. Check the following link for more details about cost. (Ref:https://www.healthline.com/health/total-knee-replacement-surgery/understanding-costs#1)

 

5.- Complications and risk of knee surgery. 

The older you are and the worse your health is, the greater the risk. Complications include:

     a) A prosthesis component can become loose or dislocate if it does not seal to the bone well or is misaligned.

     b) Legs may be slightly different in length after surgery. In some cases a shoe insert can remedy this problem.

     c) The new knee may be stiff. Most people who have undergone knee replacement can bend their knees at least 115 degrees. However some people develop    scar tissue that hinders flexibility. This limited flexibility is more common in people who had limited flexibility before surgery.

     d) An allergic reaction to the bone cement can occur. In these cases the bone cement and prosthesis must be removed. 

     e) Damage can occur to the knee's patella(knee cap) and or soft tissues (muscles, ligaments and tendons) that support the joint between the tibia and the femur.

     f) In some cases there is damage to surrounding arteries, veins and/or nerves.

     g) Deep venous thrombosis(DVT).

     h) 200% to 300% increase risk of bleeding stomach ulcers.

     i) 3100% increase risk of heart attacks in the first two weeks after surgery. And here are the references: (Ref: https://www.arthritis-health.com/surgery/knee-surgery/total-knee-replacement-risk-and-complications)

 

 

Now, what other alternatives are there that offer any significant chances of the you avoiding surgery? 

There are a variety of regenerative medicine techniques that are available today and that are becoming very popular alternatives to surgery! Many patient avoid surgery all together or at least pospone postpones surgery for several years with simple Regenerative Medicine Procedures such as Prolotherapy, PRP, and Stem Cell Therapy that are done at the doctors office. You walk in and out in about one hour and a half. We encourage you to find out more about this techniques before you plunge into a major surgical procedure specially when the damage done at times is irreversible. Talk first to friends who have had a knee replacement and se what they tell you. And remember, surgery should always be your last choice and you can always have it done later if all els fails!!

 

 

Give us a call! you will be glad you did!

At our office we perform all the regenerative medicine procedures for arthritic conditions. We were the pioneers in Northeast Florida.  We use the only DEA approve procedure with live stem cells obtained from your own bone marrow. Remember, that there are out there all kinds of gimmicks procedures being sold including amniotic fluid and umbilical cord procedures that do not contain any live cells of any kind.Beware! 

 
Sunday, July 15, 2018
By Edward Dieguez Jr. MD PA
Pin It

Where are the sacroiliac joints? 

 They are located in the lowermost part of your back. There is one on the right and one on the left side. These joints as the name implies are formed by the sacrum in the middle sore of as a wedge in between the right and left iliac bone. On top of the sacrum sits the lumbar spine.  Strong ligaments in front and in the back hold the bones together. The actual articular surface of each joint is very irregular. 

 

What is SI joint dysfunction? 

It is improper movement of the joints that connect the sacrum to the iliac bones. 

 

What can cause it?

*Pregnancy or recent childbirth 

*Lower lumbar fusion

*Leg length disparity

*Scoliosis

*Contact sports

*Regular heavy lifting, or labor-intensive jobs

*Pelvic or low back muscles unconditioned combined with prolong sitting 

*Direct result of injury or trauma, such as the jolt from a fall

 

What are the symptoms?  

Lower back pain usually unilateral dull and aching. Pain usually spread to the hips, buttocks and groin. Sciatic-like pain from sacroiliac joint dysfunction rarely extends below the knee and may include numbness and tingling. Reduced range-of-motion in the lower back, hips, pelvis, and groin, which may cause difficulty with movements such as walking up stairs or bending at the waist.

 

How to diagnose SI joint dysfunction?

There is no single test to diagnose it. Among the test used we have the sacral thrust test, the distraction test and the Faber test.  However an injection of the SI joint in question is the gold standard for diagnosing that the SI joint is the source of the pain. 

 

What are the treatment options? 

After a good diagnosis is made, basically the treatment  will depends on the severity and on how long you have been suffering from it. Conservative therapy is always better than surgery and much less risky. Initially and if not too severe or prolonged, prescription NSAID along with prescription muscle relaxants ice or heat and physical therapy including manual manipulation may be best.  A pelvic brace or support may be useful for a hypermobile joint. 

 

If all of the above fails, the most successful treatment by far with minimal risk is Prolotherapy injections using hypertonic glucose or PRP. On each Prolotherapy session, the ligaments that hold the joints together are injected precisile where they attach to the bone. This points are called Enthesis. Injection these point with the proliferant solution, stimulates the local stem cells to grow and strengthen the ligaments. These in turn strengthens the joint.  The goal here is to strengthen the ligaments that hold the joint together. Usually  four or five sessions  separated three to four weeks apart wil do the trick. 

 
Thursday, June 21, 2018
By Edward Dieguez Jr. MD PA
Pin It

What is Metatarsalgia? It is a common overuse injury in which there is DISCOMFORT and inflammation of the ball of the foot (first metatarsal head) and may include other metatarsals heads also. It is common in those that participate in high impact sports such as jumping, track and field, baseball, soccer and tennis.

 

Factors that may influence its appearance.The following factors can contribute to excessive localized pressure over the forefoot:

  • High level of activity
  • Prominent metatarsal heads
  • Tight toe extensors (muscles)
  • Weak toe flexors (muscles)
  • Hammertoe deformity
  • Hypermobile first foot bone
  • Tight Achilles tendon
  • Excessive pronation (side-to-side movement of the foot when walking or running)
  • Ill-fitting footwear

Some anatomical conditions may predispose individuals to forefoot problems. They include:

  • A high arch
  • A short first metatarsal bone or a long second metatarsal bone is often seen in people with a Morton toe; the normal forefoot balance is disturbed, resulting in the shift of an increased amount of weight to the second metatarsal.
  • Hammertoe deformity

Any or all of the above musculoskeletal problems may contribute to forefoot trauma in athletes.

 

What are the symptoms? Discomfort in the ball of the foot (first metatarsal) or other metatarsals aggravated by walking or running. Patient may also describe the feeling of like walking on marbles or pebbles. 

 

What treatment work best? After the correct diagnosis is made and after you have tried all the common modalities of treatments such as ice, rest, physical therapy, orthotics etc., and before any surgery is considered, you owe it to yourself to try Prolotherapy. This modality of therapy is very benign and the results are very good.  In a retrospective study done by Dr. Hauser, of 19 patients treated with Hackett-Hemwall hypertonic dextrose prolotherapy, all 100% had improvements of their pain and stiffness. Eighty-four percent experienced 50% or more pain relief. Dextrose Prolotherapy helped the patients make large improvements in walking and exercise ability, as well as produced decreased levels of anxiety and depression. One-hundred percent of patients said Prolotherapy changed their lives for the better. This article was published in the Journal of Prolotherapy.

 
Monday, June 18, 2018
By Edward Dieguez Jr. MD PA
Pin It

What is the ilio-tibial band?  

          The iliotibial tract or iliotibial band (also known as Maissiat's band or IT Band) is a longitudinal fibrous reinforcement of the fascia lata. The action of the ITB and its associated muscles is to extend, abduct, and laterally rotate the hip. In addition, the ITB contributes to lateral knee stabilization.The iliotibial band is an important stabilizer structure of the lateral part of the kneeas the joint flexes and extends. The iliotibial band runs along the lateral or outside aspect of the thigh, from the pelvis to the tibia, crossing both the hip and knee joints.

What is iliotibial band syndrome? 

           It is an inflammation and irritation of the iliotibial band basically from overuse. It can occur as it travels back and forth, crossing the bony prominence of the femoral epicondyle on the lateral aspect of the knee, as the knee flexes and extends. Iliotibial band syndrome is an overuse injury. It causes pain on the outer part of the knee when running as the heel strikes the ground.

 

Standard treatment of Iliotibial band syndrome.

           It consists of rest, ice, compression and elevation (RICE). Physical therapy helps with stretching exercises and other therapy modalities.

 

What to do if the problem keeps coming back? 

           As we mentioned above in the description of what the iliotibial band consist of, this structure is an important stabilizer of the lateral aspect of the knee joint. If there is an instability of the knee joint because of laxity of other joint ligaments, then more stress is placed on the iliotibial band and it is irritated from overuse. 

           When the iliotibial band syndrome persist or keeps recurring, it may signals an instability of the knee due mainly to lateral collateral ligament laxity. In this chronic cases an excellent treatment modality is Prolotherapy or Platelet Rich Plasma (PRP) therapy. These are advanced Regenerative medicine technique that work regenerating the weaken tissues of old injuries

 
prolotherapy