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Can A Gluten-Free Diet Relieve Joint Pain?

Can A Gluten-Free Diet Relieve Joint Pain?

Gluten Free: During a visit to my orthopedist I made a confession: �I stopped eating gluten and�this might sound a little crazy, but�a lot of my joint pain disappeared.

She smiled broadly and said, �You�re not the first person to say that.�

See�How Gluten Can Cause Joint Pain

gluten free continental-breakfast

Giving up gluten may be difficult, but it could lead to less joint pain.� Learn more:�What Are Anti-Inflammatory Foods?

I stopped eating gluten because couple of friends suggested it might relieve some unexplained symptoms I was experiencing, like fatigue and mild joint pain. I had strong doubts, but my primary care doctor and I had run out of ideas (I was waiting to see a specialist), so I figured I had nothing to lose.

See�Rheumatoid Arthritis and Fatigue

Within a week of going on a gluten-free diet, my fatigue, joint pain, and many other symptoms disappeared.

The Connection Between Gluten & Joint Pain

It turns out, researchers have long known that people with autoimmune forms of arthritis, such as�rheumatoid�

gluten free

arthritis�and�psoriatic arthritis, are at higher risk for celiac disease,1, 2�an autoimmune disorder triggered by gluten.

See�Inflammatory Arthritis

More recently, medical experts have begun to acknowledge the connection between gluten and joint pain described as non-pathologic (unrelated to disease).

Both my orthopedist and primary care provider agree that my gluten-free diet is probably keeping my joint pain and other

symptoms of inflammation in check.

See�An Anti-Inflammatory Diet for Arthritis

 

Wait, Don�t Go Gluten Free Yet�

Before you throw away your pasta and cereal in search of joint pain relief, consider these factors:

    • Going gluten free isn�t for everyone.�
      Whole grains are a recommended part of a healthy diet. No research suggests everyone should start eating a gluten free diet. But for people experiencing painful joint inflammation, eliminating gluten and other �pro-inflammatory� foods may be one treatment approach to consider.

      See�The Ins and Outs of an Anti-Inflammatory Diet

    • Food products labeled �gluten free� aren�t necessarily healthy.�
      It�s almost always better to eat whole foods as opposed to processed foods that are gluten-free, but still full of sugar or saturated fats. For example, skip the gluten-free sugar cereal and make yourself a bowl of gluten-free oatmeal or a fruit smoothie for breakfast.
    • Eating a gluten-free diet isn�t a magic bullet.�
      Adopting other healthy habits, such as making time for exercise, is essential to eliminating joint pain.

      See�Managing RA Fatigue Through Diet and Exercise

    • A health professional can help.It�s always a good idea to tell yourdoctor about lifestyle changes, including achange in diet. A doctor may refer you to a registered dietician who can recommend certain foods, helping ensure you get enough nutrients and fiber in your gluten-free diet.

See�Arthritis Treatment Specialists

  • You might experience gluten withdrawal.Many people report that their inflammatory symptoms initially got worse after starting their gluten free diet. This withdrawal stage can last days or even weeks, so you may not want to go gluten free right before a big event, like a vacation, holiday, or the start of a newjob.

No single treatment or lifestyle habit can eliminate the symptoms of arthritis, but going gluten-free may be an option worth trying as part of your overall treatment plan.

By�Jennifer Flynn

Learn More

Turmeric and Curcumin for Arthritis

Dietary Supplements for Treating Arthritis

References

  1. Rath, L. The Connection Between Gluten and Arthritis. The Arthritis Foundation.�http://www.arthritis.org/living-with-arthritis/arthritis-diet/anti-infla…Accessed August 20, 2015.
  2. Barton SH, Murray JA. Celiac disease and autoimmunity in the gut and elsewhere. Gastroenterol Clin North Am. 2008;37(2):411-28, vii.
Remedies For Joint Pain And Adrenal Fatigue

Remedies For Joint Pain And Adrenal Fatigue

Fatigue & Pain Of Unknown Origin (PUKO)

If you have fatigue and mysterious pain in your joints, muscles, and ligaments that seems to come out of nowhere, you are not alone: many people throughout the world face such issues, which are often disabling. Thousands of people per year visit their doctor in hopes of isolating the cause of such pain; most of them have tried traditional and over-the-counter remedies for joint pain to no avail.

Joint pain can be caused by a variety of accidents or existing conditions: it can be the consequence of a fall, structural issues, twisted ligaments, pulled muscles, or an underlying inflammatory condition, among other possibilities. These obvious causes are easily diagnosed by conventional methods. However, pain can also appear spontaneously, with no apparent cause and clean medical workup, making the etiology uncertain. Such pain can be associated with Adrenal Fatigue.

Migratory Pain

For those who suffer from Adrenal Fatigue, some of this pain might be migratory. Migratory pain is a type of pain that moves throughout the body with no discernible pattern. One day you may feel pain in the right side of your body, but the next day you may feel it in the left side. All too often, this type of mobile pain of unknown origin comes with underlying symptoms of Adrenal Fatigue and does not usually respond to typical remedies for joint pain, baffling doctors and many other medical practitioners.

After telling your doctor about the pain you are experiencing, he or she will likely perform a variety of tests, perhaps including an x-ray scan. More often than not, the results may seem perfectly normal, and yet the pain persists. Your doctor may decide that you have fibromyalgia, however, your pain may actually be due to Adrenal Fatigue. In those with Adrenal Fatigue Syndrome (AFS), the body is in a state of tiredness caused by advanced and chronic stress. This stress strains the adrenal glands and�disrupts the NeuroEndoMetabolic (NEM) stress response, which is the body�s main mechanism of dealing with stress.

NEM & Remedies For Joint Pain

lethargy-remedies-for-joint-pain-22589-2

The NEM stress response is a complex system in which organs and bodily systems work together to protect the body from excessive stress. The system includes six types of stress responses: inflammatory, neuro-active, cardiac, hormonal, metabolic, and detoxifying. Together, these responses work to restore the body�s normal function during times of heavy stress. It is important that remedies for joint pain do not disrupt this complex system.

The�adrenal glands are the main control�center for stress responses outside the nervous system. Your body has two adrenal glands, which are about the size of a walnut, located directly above the kidneys. They control your body�s responses by secreting cortisol, a hormone that helps your body cope with stress. Properly functioning adrenal glands are a keystone to overall health and wellbeing. Due to today�s high-stress society, however, this natural defense can easily become disrupted, allowing toxins to accumulate and do great damage to the body. Excessive and chronic stress can overburden the adrenal glands, inhibiting hormone output and causing the body�s natural coping mechanisms to fail.

As stress and fatigue advance, new symptoms and ailments associated with Adrenal Fatigue will emerge. Early stage symptoms include low blood pressure, insomnia, and lethargy; advanced stage symptoms include anxiety, panic disorders, heart palpitations, low libido, hypersensitivities to medication, and food sensitivities. All of these symptoms can negatively affect your daily life. Eventually, as the NEM stress response fails, even the smallest bodily stresses can seem unbearable because your body�s natural coping mechanisms have been slowed and overloaded.

The Detoxification & Inflammation Circuits

The liver is�the body�s primary detoxification organ, aided by the extracellular matrix. A buildup of toxins and metabolites will therefore occur when the liver slows down to conserve energy. This is the body�s way of conserving the nutritional reserves it has left. As your body slows down, your liver becomes more sluggish and levels of toxins and metabolites increase, often leading to inflammation. These toxins accumulate and are not eliminated efficiently. This accumulation causes many other problems because the blood circulates these metabolites throughout the body constantly and rapidly, with a one-minute cycle.

Some of these metabolites can be quite toxic to the body. These metabolites may trigger inflammation, which in turn can trigger pain. Upon reaching the joints, these metabolites may become �stuck,� meaning they are slow to move through the joints and muscles. If your joints or muscles are already inflamed, the toxins and metabolites will further irritate the muscles, causing additional inflammation.

The Inflammation Circuit consists of the gut, microbiome, and immune system.�The gastrointestinal tract and microbiome�play an important role in breaking down and absorbing metabolites. If you are constantly eating unhealthy foods that your body can�t handle, you may trigger inflammatory responses. If you are constipated, and food is rotting in your intestines for long periods of time, then you are at higher risk of inflammation. This inflammation causes pain in random places because of the buildup of metabolites in the bloodstream. This also slows the immune system, because it has to deal with the extra toxins, compounding the inflammation.

If you experience migrating pain, this is an important clue that the cause of the pain may be metabolic, rather than structural (such as the strain of a ligament or muscle, which is usually more confined to a certain area). If you experience a dull to slightly severe pain of unknown origin that seems to migrate throughout the body and no one can seem to give you a direct answer as to the cause, you may be suffering from Adrenal Fatigue Syndrome. Consider metabolites, examine your stress levels, and investigate your diet, including supplements. In rare cases, some medications and supplements�even those often used as a remedies for joint pain�can trigger inflammation that is fundamentally caused by Adrenal Fatigue.�Pain medications may help temporarily, but they tend to hide the underlying condition, and can cause collateral damage. Remember, pain is a sign of an underlying problem. Suppressing or ignoring pain can cause long-term damage if the cause is not addressed.

Remedies For Joint Pain: Conclusion

physiotherapy-remedies-for-joint-pain-22589-3Joint pain of unknown origin can cause a myriad of debilitating problems, including the additional stress of trying to find effective remedies for joint pain. It can be a scary and confusing time, especially when test results show no abnormalities and your doctor can�t figure out what�s wrong. It�s important to find and address the cause of the inflammation. If you experience other concurring symptoms similar to those of Adrenal Fatigue, find a practitioner who can support your NEM stress response. Proper restorative strategies will help your body cope with both the stress and the pain.

By:�Dr. Michael Lam, MD, MPH;�Justin Lam, ABAAHP, FMNM

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� Copyright 2016 Michael Lam, M.D. All Rights Reserved.

Chronic Back Pain: When There�s No Cure

Chronic Back Pain: When There�s No Cure

Chronic Back Pain: Living with chronic pain can be exhausting and frustrating. But you can limit the severity of your pain�and the effect it has on you�with the following 3 strategies:

chronic back pain Side Resume1. Become An Expert At Chronic Back Pain Management

chronic back pain Elderly woman working outNo one pain management technique works for everyone; it helps to be open to trying all sorts of methods and techniques to diminish and manage your pain.

Keeping your pain at the lowest level possible will help keep you active, which in turn will minimize your chronic pain and keep it from getting worse. It will also help decrease the stress that is often associated with chronic pain. Common pain management techniques include:

    • Cold / heat therapy
    • Over-the-counter or prescription pain medications
    • A healthy exercise regimenAside from those above, which can be done on your own, some people find alternative treatments quite helpful, such as chiropractic care, acupuncture, or massage therapy.With patience, find what combination of treatments works best for you.

 

 

2. Find A Support Network

chronic back pain Elderly men hiking

Chronic back pain can be an isolating experience. You may not be able to be as active as you once were, saying �No� to social gatherings, and limiting participation in some of your favorite activities.

As you become more isolated, your experience of chronic pain may increase because of less stimuli to distract you. You also increase the risk for developing mental health issues, such as depression.

It is encouraged you find a network of social support to limit the isolation effects of chronic pain. The key to a support network is not only finding people who are empathetic and supportive, but also finding a health distraction from the pain.

3. Practice Imagery Control Techniques

When treating your chronic back pain, it is important to remember the role your mind can play in reducing your perception of chronic pain.

In particular, imagery control techniques can bring you meaningful relief in a matter of minutes. You can start by trying �the altered focus technique.� Here is how to do it:

  • Focus your attention on a part of your body other than your lower back.
  • Next, alter the sensation in that part of your body. For example, you can imagine your hands becoming cold or warm (whichever feels better).
  • Hold this sensation in your hands for several minutes, and your experience of pain will likely diminish.You can practice these techniques wherever, and however often, you want.If the above three strategies don�t help reduce your chronic pain, don�t despair. Instead, ask your doctor for a referral to a pain specialist to discuss other possible options for chronic back pain relief. There are a great many approaches to pain management.

Talk to Dr. Jimenez about specific questions related to your unique health situation.

915-412-6677

Learn More:http://www.spine-health.com/doctor/chiropractor/alex-jimenez-el-paso-tx

Chronic Inflammation: Chiropractic Treatment

Chronic Inflammation: Chiropractic Treatment

Chronic inflammation remains a confusing subject for many. One reason for this is that chronic inflammation does not resemble acute inflammation and is not associated with conditions that are normally treated with medications, spinal manipulation or surgery.

Chronic Inflammation Needs To Be Understood

chronic inflammation doctor stethoscope heartDD Palmer wrote a chapter in 1914 entitled Inflammation, stating that, “inflammation is present in most, if not all diseases, in the acute if not chronic.” 100 years later, all chronic diseases are inflammatory conditions within local tissues . Chronic systemic inflammation and related pathophysiological changes involve structures and functions that are silent.

Chronic inflammatory condition alters the structure and function of a given tissue and is identified by symptoms and laboratory tests. This enables the application of a name, which describes the chronic state, such as osteoarthritis, fatty liver, tendinosis, diabetes, widespread pain, depression, osteoporosis, heart disease, Parkinson’s disease, Alzheimer’s disease and cancer.

 

Lifestyle Choices That Promote Chronic Inflammation

Chronic InflammationLoss of sleep, sedentary living, stress and diet all encourage inflammation.

Dietary interventions may appear confusing and complicated. The first step is to assess inflammatory markers during the examination, which will offer insight for a lifestyle change and management.

Markers For Chronic Inflammation

Laboratory tests are the best approach to spot chronic inflammation. High levels of glucose, triglycerides, hemoglobin A1c protein along with reduced levels of vitamin D and HDL cholesterol are the most reliable in identifying chronic inflammation.

Patients can also fill out a Health Survey Questionnaire (HSQ-12), which identifies health status, which directly correlates to chronic inflammation.�Without doing a lab test,� chronic inflammation can be indirectly measured.

Nutrition For Chronic Inflammation

unhealthy foodsDiet is a problem for most people with over two-thirds of the population being overweight. Obesity is known to be a chronic inflammatory state associated with chronic pain and degenerative diseases.

Do no focus on the food for a dietary change and instead focus on the inflammatory markers aforementioned. Food can be emotional, with the markers being objective. Avoiding emotion and stress is a way to deal with nutrition effectively, along with weight loss.

The most essential element in reducing inflammation is caloric restriction. Becoming overweight comes from eating too many calories, whether they comes from fat, flour or sugar. Americans, on average, acquire 60 percent of their calories from flour, sugar and oils. The solution is to replace the refined calories with vegetation calories that allow for greater food consumption with lower calories.

Dietary options that can help:

  • Vegan
  • Omnivore
  • Ketogenic

The important thing is to avoid extra salt, flour, refined oils and refined sugar.

Overview

One does not need to understand the chemistry of chronic inflammation to employ an anti-inflammatory lifestyle. It is crucial to understand that inflammation is the underlying cause of disease and most chronic pain.

Fibromyalgia Can Mask Chronic Inflammatory Disease

Piriformis Syndrome

Piriformis Syndrome

Ever felt pain in your hip, the center of the buttocks, or pain down the back of the leg, you’re likely suffering, at least partly, with piriformis syndrome. The piriformis is a muscle which runs from the sacrum (mid-line base of spine) into the outer hip bone (trochanter). This muscle works overtime on runners.

The muscles in and about the gluteal area help with three areas

� rotation of the hip and leg;
� balance while one foot is off the ground
� stability of the pelvic region.

Needless to say, every one of these attributes are highly needed by runners and everyone else.

Piriformis Injuries

RMI or repetitive motion injury occurs when a muscle has to perform beyond the level of its capability, not given time to recover and doing it again and again. The normal response from a muscle in this situation is to tighten, which is a defensive response of the muscle. This stimulation, however, manifests itself several ways.

First Symptom�indicating piriformis syndrome could be pain in and about the outer hip bone. The tightness of the muscle generates increased pressure between the bone and the tendon which produces pain and either discomfort or an increased tension in the joint which produces a bursitis. A bursitis is an inflammation of the fluid filled sac in a joint caused by tension and strain within that joint.

Second Symptom suggesting piriformis syndrome would be pain right at the middle of the buttocks. Although this is not as common as the other two symptoms, this pain can be brought on within the fatty part of the buttocks region with direct compression. A tight muscle becomes a sore muscle upon compression because of reduced blood flow to that muscle.

Third Symptom indicating piriformis syndrome would be a sciatic neuralgia, or pain from the buttocks down the back of the leg and at times into different parts of the lower leg.

The sciatic nerve runs directly through the belly of the piriformis muscle and in the event the piriformis muscle contracts from being overused, the sciatic nerve now becomes strangled, producing pain, numbness and tingling.

Physiology

piriformis syndrome illustration of athlete runningAny muscle constantly used has to have an opportunity to recover. This recovery can be natural with time, or could be facilitated and sped up with treatment. Continuing use will make it even worse since the muscle is tightening due to overuse. This injured muscle needs to relax and have blood flow encouraged into it for a rapid recovery. The tightness� lessens the normal blood flow going to the muscle. To encourage new blood into the muscle is the way of getting the muscle to begin to unwind and operate normally. Massages daily to this area is greatly supported.

The next step in this “recovery” process is to use a tennis ball under the butt and hip area. Roll out from the side of engagement while sitting down on the ground and set a tennis ball inside the outer hip bone under the buttocks area. Note areas of pain and soreness, as you start to allow your weight onto the tennis ball. Trigger points will have a tendency to collect in a repetitively used muscle, and till these toxins are manually broken up and removed, the muscle will have an artificial well being concerning flexibility potential and recovery potential. Consequently, if it’s sore while your sitting on it, you’re doing a good job. Let the ball operate under every spot for 15-20 seconds before transferring it to a different place. After 4-5 minutes place cross legs with the ankle of the affected leg over the knee of the non-affected leg. Then place the tennis ball just inside the outer hip bone and work the tendon of the muscle. Although this pain requires some time to reduce and is excruciating, the advantages are enormous. Be patient and good things will happen.

Treatments

Due to how the sciatic neuralgia and the hip bursitis or tendonitis are both inflammatory in character, ice therapy, or cryotherapy, within the involved region 15-20 minutes at a time will be beneficial. This should be performed multiple times each day.

Once the acute pain is gone then start with gentle stretching, like a cross-legged stretch while pulling up on the knee. The muscle should have improved flexibility.

Finally the use of pharmaceutical anti-inflammatories are not encouraged. One the intestines are greatly aggravated by them, but they also suggest an artificial wellbeing that can lead to larger problems. Proteolytic enzymes, such as bromelain, extremely beneficial without any side effects and are organic.

Piriformis Syndrome & China-Gel

Migraine Headaches: National Upper Cervical Chiropractic Association

Migraine Headaches: National Upper Cervical Chiropractic Association

Migraine headaches, a clinical study involving 11 migraine patients and NUCCA care was recently conducted. Let’s take a look at the results and reveal the benefits of NUCCA care and how the study was conducted.

Method Of Study: Migraine Headaches

lady migraine headache pain el paso txThe 11 patients in the study had never experienced upper cervical chiropractic care before. All were subject to having migraine headaches and were required to have at least 10-26 days with a headache for the previous four months. Additionally, at least eight of those headache days per month required a 4 out of 10 or higher for pain. While many candidates had either a concussion, auto accident or both, candidates who experienced trauma in the past year were excluded.

NUCCA professionals used various kinds of testing to evaluate the patients. Supine Leg Check Screening tested patients� for visible signs of one leg being shorter, which may indicate atlas misalignment. Gravity stress analyzers were used, as well as, calipers for detecting asymmetry in the pelvis were used. A typical NUCCA radiograph series also includes three x-rays a lateral cervical film (side view), a nasium film (back view), and a vertex film (top view) to identify specific misalignments.

migraine headaches NUCCA-OrganizationAccording to these diagnostic methods, the practitioner then prepares an alignment specifically designed for the patient involving the patient’s position, the stance of the practitioner, and the suitable force vector for atlas correction. Patients were given between one and five corrections.

Outcome: Migraine Patients

Headache days per month decreased for patients on average. 14.5 headache days per month was the norm. After one month of NUCCA treatment, patients experienced 11.4 headache days per month. At the conclusion of the two-month study, patients were down to 8.7 headache days per month.

Quality of life measurements in three categories also improved radically within the course of two months:

  • Restrictive enhanced from 38.4 to 73.5
  • Emotional improved from 53.3 to 81.2
  • Physical improved from 54.1 to 86.8

MIDAS score (which measures migraine headaches in the form of level of disability caused) improved from a mean of 46.7 to only 14.6.

While further studies are necessary to offer a quantifiable method of documenting the physiological changes which take place because of the corrections, the results speak for themselves as to the advantages of NUCCA for migraine headaches, especially those with a history of neck or head trauma.

Chiropractic & Headaches

Eliminate Headaches And Migraines Juice Recipe

green juice migraine headache eliminator el paso txHeadaches and migraines. The only thing you want is for it to vanish. Here is a juice that immediately eliminates headaches and migraines! Try this juice recipe out, in addition to getting an adjustment!

Headaches and migraines are often the result of stress, poor diet, poor posture, emotional tension or exposure to environmental toxins. People reach for over-the-counter medications to help ease the pain, but there are much safer and natural ways of getting rid of headaches.

This juice is loaded with minerals such as magnesium and calcium, two crucial components in helping prevent and alleviate headaches. A juice as opposed to these foods in solid form will help nutrients reach the bloodstream faster, alleviating headaches and migraines in a jiffy!

  • 5 stalks celery
  • 1 cucumber
  • 1 cup parsley
  • 2 granny smith apples
  • 3-4 cups leafy greens (ex. spinach, arugula)
  • Two inches ginger root
  • 1 lime

METHOD:

Blend all ingredients in a juicer, blender, food processor and enjoy immediately to preserve freshness and antioxidants!

Back Pain Myths: Revealed

Back Pain Myths: Revealed

Back Pain Myths

Myth 1: You Only Have To Sit Up Straight.

Back pain myths are like any other, however, your mom was not totally wrong; hunching can certainly be bad for your back. But the opposite is true as well. Strain can be also caused by sitting up for too long without a break. If you work make sure that your chair is at a height where your knees are at a 90-degree angle, your feet can rest flat on the ground, and you have back support. Make sure that you stand up, stretch, and take a walk several times each day to keep from becoming stiff or causing injury.

Myth 2: You Need The Firmest Mattress Possible.

Back pain sufferers can actually experience increased pain if their mattress is too firm since it puts more strain on heavy points like the hips and shoulders. On the other hand too soft a mattress could lack the support required to allow proper movement. In both instances, the person wakes up stiff and in pain. Studies show that a medium-firm mattress provides the right amount of support to help prevent injury.

Myth 3: Back Pain Is Caused By Exercise.

A poll by the North American Spine Society revealed this as the number one back pain myth. Sure, if you don’t work out then try to win a competition, you could experience injury. You can help prevent back pain by preparing your body and workouts with proper warm-up and great stretching exercises. (Take a cue from professional athletes that factor stretching and warm ups in their everyday routine.) Strengthen your back by strengthen your core, through exercises focused on�strengthening your stomach and back muscles as well as cardio.

Myth 4: Back Pain Is An Unavoidable Side-Effect Of Getting Older.

Getting older does not mean life has to be painful. While there are aches and pains that come with an aging body, staying physically healthy (see Myth #3) through exercises that keep our bodies strong, flexible and limber are a huge benefit. There are several exercise options to try, T�ai Chi, Pilates, yoga and treatment options which range from acupuncture to physical therapy to advanced treatment options both surgical and nonsurgical. Bottom line is you do not have to live with back pain.

Myth 5: Back Pain Came Out Of Nowhere.

Another back pain myth is sufferers often claim one wrong twist or simply bending over was the cause of their injury. But that was likely the result of several other factors. Overdoing a workout, using poor technique when lifting heavy objects, bad posture, and especially weight gain can all put strain on the spine and lead to “out of nowhere” spasms. As with more serious conditions such as joint and disk disorders a spine doctor is recommended to find the source of the pain.

Myth 6: A Hot Bath Can Bring Relief

There are few things as relaxing as a nice spa, but doing so after injuring your back may actually make your situation worse by increasing inflammation. Doctors recommend applying ice to the area for 20 minutes at a time during the first two or three times in order to reduce pain and inflammation. An exception, people who suffer from chronic pain can find relief taking a warm bath. Play it safe and check with your doctor for the best treatment.

Myth 7: If I See A Doctor, I’ll Probably Have Surgery.

Most people will experience some level of back pain in their lifetime, but the overwhelming majority will find relief through modifications such as over the counter anti-inflammatory medicines, exercise, physical therapy, or even just by waiting it out. In actuality, spine surgery is recommended for a small percentage of patients and until all other treatment methods have been tried. These patients often suffer from degenerative spine or joint problems that cause pain that is chronic. Whether you understand the origin of your pain or not, a fear of surgery shouldn’t prevent you from seeking medical help.

F4C Jerry Rice Poster

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