Depression ICD-9 296.3, Chronic Fatigue Syndrome ICD-9 780.71, Fibromyalgia ICD-9 729.1
My first exposure to the connection between inflammation and diseases was in the paradise island of Bali Indonesia in 2005.
No, I did not get inflamed skin from sun burn laying at the beach. I wish! It was in a lecture hall at a medical conference.
While lecturing in Indonesia in 2005, I attended a lecture given by Dr. Bill Anton who discussed the connection between chronic inflammation and the diseases of aging such as heart disease. It was that experience that inspired me to write this book because I had an “A-ha!” moment:
Chronic Inflammation comes from:
- Your Diet – The food you eat. (even if it’s natural or unprocessed)
- What you breath in. (pollution, sprays, allergens, ect.)
- What you touch
- Abnormal Walking Patterns (even if you are not in frank pain)
This was a presentation given to medical physicians, backed by research studies and position statements by the American Heart Association.
- AHA/CDC Scientific Statement
- American Heart Association
- Links Between Inflammation and Cancer
- Links Between Inflammation and Nervous System Disorders Like Parkinsons
- Links Between Inflammation and Depression
After that lecture I realized how much more I was doing for my patients besides helping them reduce their pain and improve their function. If what we do is reduce bodily inflammation then are we helping them reduce the risk of the diseases of aging?
I immediately flew back to Chicago and began doing extensive research on how diet affects the levels of inflammation in the body.
In 2006, my abstracts on diets and their effect on levels inflammation were accepted for presentation at medical conferences in Madrid Spain and Hong Zhou, China.
Maybe you chalk up your sore swollen gut to what you ate but when you keep eating the same thing and this does not go away when do you become concerned about more serious risks? You can live with the daily aches and pains and aspirin takes the edge off but are you aware of the risks you are taking by leaving these inflammatory conditions extending into weeks, months, years and even decades?
More studies have to be done to understand this problem more clearly however the scientific community has done studies that suggest this chronic inflammation is not healthy for you.
The scientific and medical communities have known for a decade that inflammation increases the risks for diseases of aging such as heart disease, stroke, Alzheimer’s, Parkinson’s, and even some cancers.
Many of you haven’t heard this but instead have heard to use fish oil and take an aspirin a day. I have asked the media and doctors why this has not been exposed to the public more and a few told me it wasn’t a sexy subject. It was a boring story.
So while the media ignores what is important for your long term health the world gets sicker!
I’m advising you that you really should talk to your doctor about inflammation and if you think you are chronically inflamed there are blood tests to get a more accurate assessment of your levels of inflammation.
The Dangers of the Chronic Use of Pain Killers!
When it comes to strong narcotics that can be a different story. Some patients are a lot of pain and sometimes I can understand their rationale for taking more than less. It hurts!
However, pain serves an important function. It provides a warning signal that something is wrong. Sometimes its hard to get an accurate picture of their level of inflammation and where it is due to the pain killing effect of the drug blocking the warning signs of the high level of inflammation.
If you read the book, How I Got My Wiggle Back by Anthony Field and Greg Truman, he tells the story of how dental decay went uncontrolled to the point where the inflammation and infection spread into his jaw bone and skull. That is because he couldn’t feel the pain that would have warned him of the tooth decay early on.
He almost died. Thank God they caught it, just in time.
Sometimes Narcotics Block the Warning Signs of Conditions and or Potentially Fatal Diseases
I had a talk with Dr Rutledge, a doctor from Los Angeles. We discussed the biggest danger of the daily or regular use of these strong narcotic pain killers. They could be blocking the warning signals from inflammation that are coming from a blocked colon, an ectopic pregnancy or some other disease that is getting progressively worse.
If you are taking narcotic pain killers or over the counter medication for pain, you really should have a talk with your doctor to work out a game plan to do what it takes to make sure there aren’t any serious disease or conditions worsening that you might be unaware of due to the narcotics blocking the pain signal.
Silent Dietary Inflammation:
When I palpate the gut on some patients it can be very painful. This could be a sign of gut inflammation, inflammation of the internal organs like the liver, kidneys, intestines, reproductive system, bladder, pancreas etc. If you push on your gut and it hurts you should contact your doctor to see where the pain is coming from right away.
Chronic illnesses that often come along with inflammation are: diabetes, atherosclerosis, Alzheimer’s, heart attack. “Inflammatory factors predict virtually all bad outcomes in humans,” says Russell Tracy, a professor of pathology and biochemistry at the University of Vermont College of Medicine, whose pioneering research helped demonstrate the role of inflammation in heart disease. “It predicts having heart attacks, having heart failure, becoming diabetic; predicts becoming fragile in old age; predicts cognitive function decline, even cancer to a certain extent.
Blood Tests Can Allow a More Accurate Measurement of Levels of Inflammation:
You should really get a blood test to check for your levels of inflammation. Have a talk with your doctor about these tests. If the test results show you have high inflammation, then take the steps to systematically reduce it.
The self help tips I give you in this blog are very useful to start the process. You can also read Anthony Fields book, How I Got My Wiggle Back because that was the approach we took for him.
When you have chronic inflammation your health can spiral downward because of the vicious cycle that results from the body’s response to inflammation.
Conditions Linked With Chronic Inflammation:
- Periodontal disease
- Metabolic Syndrome
- Heart disease
- Vascular disease (not to mention unsightly varicose veins!)
- Respiratory disease
- Chronic fatigue
- Increased risk and compromised healing of infections
- Brain Fog
- Kidney disease
- Parkinson’s Disease
- Alzheimer’s Disease
- Some Cancers (yes, I mentioned that frightful word again!)
Inflammation can exist in the form of pain but you do not have to have pain to have higher than normal levels of inflammation. In fact doctors and scientists are finding that “silent” or non-painful sources of inflammation are the most destructive because they exist without your knowledge so they perpetuate damage in your body for months, years or decades without your intervention leading to permanent damage and even death.
Levels of Chronic Inflammation:
Levels of Arthritic Inflammation – The most accurate levels of testing for inflammation is a blood test. (see bottom of post) If we don’t have access to a blood test, we have to qualify the inflammatory state of your body by way of your symptoms and signs from the examination.
Then we can chart the levels of pain via Borg Pain Scale on a medical chart and begin as we work our plan to reduce the inflammation.
Levels of Systemic or Dietary Inflamation – Its best to work on all potential sources of inflammation at the same time. You need to combine the effect of the arthritic inflammation (inflammation coming from muscles, joints etc) with the level of inflammation from your diet. You also have to account for inflammation in your sinuses, breathing tubes and lungs from airborne particles that inflame the lungs like pollution, sprays, perfumes, allergies etc.
Dr Stoxen’s Zones of Inflammation
Inflammation is both overt and silent
I explain it by using the colors of a stop light
GREEN or more or less healthy levels of inflammation:
This is a more acceptable healthy level of inflammation that is not considered harmful to you.
In fact you need inflammation to protect you when necessary.
Inflammation plays a vital roll in your immune response. Your body depends on inflammatory processes to defend you from invaders like bacteria, viruses and even cancer cells. Inflammation also helps the body heal from injuries.
If your levels of inflamation are in the normal or my green phase we also assume you are walking with less stress on your muscles and joints.
The ultimate example of a healthy spring protective mechanism is someone who is capable of barefoot running on the worlds hardest surfaces and/or high impact plyometric exercise without a problem. We have to assume that those who can absorb greater forces of impacts without pain or release of inflammation have healthy functioning biomechanics.
I have trained myself and many of my patients to this level and recommend you strive for this level of protection from impacts.
Silent Arthritic Inflammation – This could represent someone who is not in real pain but has decreased performance and/or a risk of injury due to the internal compressive forces resulting from abnormal movement of the body (I call it locked or stiff human spring). They feel no pain but a flaw is noted in their gait pattern that suggests abnormal stress and strain on their body that has the potential to release inflammation. You probe into the most likely area and find an abnormally painful spasm pattern.
Dietary Inflammation – Doctors have described this as inflammation that comes from a diet that has foods that the individual is allergic to, hypersensitive to and some suspect foods which are high in arachadonic acic.
Airborne sources of Inflammation – Airborne or environmental sources of inflammation like pollution, cigarette smoke and allergies.
Food, like exercise is meant to improve health. In this situation it is causing accelerated aging through the inflammatory response. So if you eat food that you are hypersensitive to or down right allergic to then you are certainly causing detriment to your health and a higher risk of diseases of aging in the long run.
Most of my patients except those I am training for a championship sports competititon fluxuate between the yellow and red phase of aging. The gold is reserved for those who are in top physical shape and have a progressive anti-aging protocol set up by a qualified doctor.
RED or painful inflammation:
Frank Inflammation, which means that the patient is actually is inflamed to the level of which come see you since they are in pain. This is when the patient is actually in pain because the levels of inflammation are very high. The spring mechanism is so locked that the patient releases high levels of inflammation with every step that accumulate in the tissues in concentration levels that can be felt by the patients brain. (Remember that this is conceptual discussion to help you understand your state of health.)
An example of the red inflammation when you are in pain.
When we are talking about walking or running arthritic inflammation this is when your body cannot spring from the impacts like a spring mechanism. The spring mechanism is weakened, stiff or locked. My feeling is that exercise on a spring mechanism that is not capable of withstanding the impacts of every day walking then every step you take is causing the release of inflammation. (theory) That means that exercise may actually be aging you faster than helping you.
Another example is when you eat something that gives you a stomach ache or when you have ulcers.
- Arthritic Swelling, Raised Skin Temperature, and Pain
- Susceptibility to Decreased mobility
- A More Sedentary Lifestyle Because You Are Afraid To Exercise
- Susceptibility to Weight gain
- A tendency towards Catabolism (Tissue Breakdown) vs Anabolism (Tissue Repair and Growth)
- Susceptibility to Fatigue
- Severely decreased growth hormone level
- Susceptibility to a Poor Concentration (Brain Fog)
- Potentially Higher risk for injury
- A Misdiagnosis of a Restless Leg Syndrome
- Susceptibility to Insomnia
- Susceptibility to Depression
For Example: I have a back pain with hip pain and I have mild foot pain occasionally. I go to the doctor for back pain and he asks if I have any other pain. You say my foot hurts once in a while. It seems insignificant however the concentrations or levels of inflammation are not the determining factor in diagnosis or how we should treat the patient.
What is a good game plan for preventing inflammation?
My approach with patients is to list and check off all potential sources of chronically high levels of inflammation. Then we put together a plan to systematically reduce as many sources of inflammation we can.
Of course, most patients come to me for aches and pains so we start by getting them out of pain (very high levels of inflammation) and work to return their function.
After we reduce the areas of high concentrations of inflammation (where it hurts) we address the less obvious sources of inflammation on the list.
I don’t just treat the area with the most inflammation or the area of your body that hurts. if I feel there is a connection between one joint to another or if the entire body is inflamed from toe to head I start at the foundation and work to make improvements on joint motion from the foot up.
I treat you as a doctor and coach you to improve the form and technique of your movement patterns like a sports coach.
I treat the body to improve or restore its natural elastic recoil or spring with the goal of restoring the bodies ability to spring off the ground when you walk.
I look at your body as an integrated spring mechanism and work to improve walking and running technique to reduce the abnormal movement patterns that could be causing the stress and strain, wear and tear, possibly leading to the release of inflammation.
If you think an aspirin can that reduce inflammation? Clinically, I have seen patients who take several aspirins every day but are still inflamed. You would think they would be numb when Im examining their body for these patterns of silent inflammation as the inflammation in these areas are not as high as the main area of pain. What I have found is that we can still track these areas of silent inflammation even when they are on aspirins and nsaids.
So the medication in some cases has limited effect depending on how inflamed you are. Also if the inflammation is coming from abnormal walking patterns and you haven’t corrected the pattern I guess the inflammation is still going to be produced.
Some of these patients literally wince in pain when I lightly probe a muscle. They think I am hurting them. Then I move to an area I know is not a part of the pattern of spasm and push much deeper and they feel no pain. This helps them to understand that there is a difference in the concentration of inflammation in that part of the body over another. I always explain that Im not hurting you, it just hurts because of the high concentration of inflammation.
I examine the body as an integrated human spring mechanism.
In other words, If we are going to address regional pain in the back, then we also need to track this through the entire integrated mechanism of the human body (the human spring) for a pattern that leads down to the foot, if there is one. I feel this is a thorough evaluation. What does it hurt to check? I check every patient for abnormality of gait because it is common. Also, its easy to instruct patients to improve their walk as they have to walk anyway so why not work to improve your step?
Can you tell when someone has a bad golf swing or throwing motion?
Most can see when someone has a terrible golf swing and most can see when someone is a great athlete or just a novice. Its seems obvious. That is because if you are a fan you have watched the patterns of movement of the elite and can see a big difference between a weekend warrior and a pro.
Certain abnormal walking patterns for me at also poor or elite. Patients don’t know it but I am checking for their form and technique and like a coach know what to look for.
I remember watching the USA National Team Coach for rhythmic gymnastics, Irina Vdovets would evaluate three and four year olds for their sports potential based on their flexibility and movements. I asked her what she looked for in a potential national champion and she explained very logically.
I am not going to go into that as I may be exposing her secrets but lets just say she coached 15 or more girls to national titles and many who competed in the Olympic Games so lets say she knew what to look for too, genetically.
Im not talking so much about genetics.
What I am talking about is this…
An elite running coach can watch an athlete run and by checking form and technique of things such as toe point, body position, if they land heel, mid foot or forefoot and tension on the body at landing and determine where the flaws are. They then coach the athlete how to make these changes and their running efficiency and ability to resist injuries can improve.
We can attempt the same thing with your walking and running.
What is the best way to examine your own walking form and technique?. It doesn’t have to be too expensive. I have found value in this approach.
Just get a $150 HD flip video camera that every 14 year old seems to have or use your iPhone video camera and film your walk for 10 steps with your socks and shoes off and shorts. Download the video and watch the video very slowly by moving the curser. Its amazing what you will see.
In fact, I have given workshops at the Royal College of Physicians, at the Congress of Anti-aging in Sao Paulo, Brazil and at the Bumrungrad Hospital in Bangkok Thailand, I asked random doctors to come to the stage, watched their walk and just from their walking pattern was able to fairly accurately determine conditions they had. Doctors astute in gait evaluation can detect evidence of disease processes with gait evaluation.
For me, seeing how your body moves during walking tells me a lot more than just x-rays, MRI and standard orthopedic and neurologic evaluations. I do all those plus the gait evaluation to get the most through understanding of the problem.
If you have abnormal movements in the feet and legs, then that can cause stress and strain in your muscles, ligaments, tendons and bones. This can lead to the release of inflammation in the affected area.
CONNECTING THE KNOTS
What I have found clinically in my practice is this… When the abnormal motion is happening at the foot, I have found patterns of inflamed muscles, ligaments and tendons in patterns that link and are predictable depending on the way the body compensates for the abnormal plant of the foot.
Over the years of lecturing around the world, many doctors and scientists have shared with me that they have noted the same similar findings.
I call this method of examining the patient, ‘connecting the knots.’
How do you know where the pattern is?
It is quite simple. It is more painful to the deep touch and there are ropy sensations in the area of where more soft muscles should be. We call these simple painful spasms.
When you feel foot pain, knee pain, and your back hurts, you may be interested to know that I find in clinical practice these conditions could connected may be traceable down to a flaw in the landing of the foot.
I track them down throughout the floors of the body on the examination table noted by a painful pattern of spasm by probing the muscles.
I know where they are before I examine the patient because I have found in practice that the spasms are activated by the brain in an attempt to protect you from the abnormal movement They call them tonic protective reflexes.
When muscles on one side of the bone contract the muscle on the opposite of the bone has to relax to allow for the unrestricted movement of the bone. They call this reflexive inhibition. The brain turns off the opposing muscle for you automatically.
When muscles on all sides of the joint contact at the same time they compress the joint. If this happens for too long the compression combined with movement is not healthy for the body.
Why are the spasms predictable?
This is how I explain it…
Gravity is predictable.
Physics is predictable.
The engineering of the human body is fairly predictable.
The compensation patterns related to an abnormal gait or walking pattern all start falling into predictable patterns after you have watched several hundred or in my case several thousands of people and their walking form and technique.
Doctors give names to particular gait or walking patterns like:
For example in this article from the New York Times it lists the gait abnormalities by names and their causes:
The New York Times
Monday, March 19, 2012
- Propulsive gait — a stooped, stiff posture with the head and neck bent forward
- Scissors gait — legs flexed slightly at the hips and knees like crouching, with the knees and thighs hitting or crossing in a scissors-like movement
- Spastic gait — a stiff, foot-dragging walk caused by a long muscle contraction on one side
- Steppage gait — foot drop where the foot hangs with the toes pointing down, causing the toes to scrape the ground while walking, requiring someone to lift the leg higher than normal when walking
- Waddling gait — a duck-like walk that may appear in childhood or later in life
Abnormal gait may be caused by diseases in many different areas of the body.
General causes of abnormal gait may include:
- Arthritis of the leg or foot joints
- Conversion disorder (a psychological disorder)
- Foot problems (such as a callus, corn, ingrown toenail, wart, pain, skin sore, swelling, or spasms)
- Injections into muscles that causes soreness in the leg or buttocks
- Legs that are different lengths
- Shin splints
- Shoe problems
- Torsion of the testis
(The above list does not include all causes of abnormal gait)
Causes Of Specific Gaits
- Propulsive gait:
- Spastic (scissors) gait:
- Steppage gait:
- Waddling gait:
- Ataxic or broad-based gait
- Acute cerebellar ataxia
- Alcohol intoxication
- Brain injury
- Damage to nerve cells in the cerebellum of the brain (cerebellar degeneration)
- Medications (phenytoin and other seizure medications)
- Polyneuropathy (damage to many nerves, as occurs with diabetes)
You don’t have to have one of these diseases to have an abnormal walking pattern. Here are some of the daily events-which can change your gait:
- An injury causing you to compensate
- Surgery anywhere in your body
- Psychological manifestations
- Stress causes tension in the natural spring mechanism
- Mastering a specific sport motion can alter your normal walking pattern
- Being overweight or obese
Some muscles are in pain without being touched or through what we call deep palpation. The muscles and joints that hurt without pressure applied are what I call frank pain or obvious pain.
Muscles that ONLY hurt when you apply deep palpation I call silently inflamed. That is because they are abnormally inflamed mostly due to abnormal stress on them. We are not talking about blunt trauma injuries.
I find they connect through these patterns of spasms but oftentimes, the patient doesn’t know they have them because they don’t feel the pain unless you do deep palpation probing into the muscle to find it.
We sometimes feel painful knots when we get massages in a particular area we did not know hurt. What I have found is that these are not so random but tend to connect together in a linkage because the body moves via linkages.
Like I said, “I call these areas of inflamed tissue that are only painful with deep pressure, silent inflammation.” By checking for “silent” arthritic inflammation we can start to connect conditions to the inter-linking human spring mechanism I talk about in my lectures.
Connecting the knots from the foot to the back and beyond!
What if I have a problem in my back that is connected to my foot plant but the doctor only examines my back and ignores the connection to my foot plant?
If you feel strongly that your back pain is somehow connected to your foot plant then show the doctor. If he or she doesn’t routinely check gait as this is not their specialty then seek out a doctor who knows how to evaluate and coach you on what to do to improve your gait.
When I do a video of the patient walking pattern it takes 30 seconds or less to video the walk, 2 minutes to load it into the computer and 10 minutes to go through it frame by frame while I detail for the patients the flaws in the patterns of their walk. Its worth 15 minutes to be more thorough to perhaps understand better why you aren’t healing.
Sometimes your back problem isn’t something your GP specializes in so they might order an MRI thinking they are doing you a favor by just telling you what it is and not why it is not healing.
When a patient comes into my office with the MRI that says they have a herniated disc I thank them for the information and they are shocked when I tell them that I feel it is not the MOST important factor in their case.
The most important factor is WHY IS THE DISC NOT HEALING?
That is a shocker to the patient. However, when they think about it logically, they are wondering the same thing!
It should have healed by now!
Why isn’t my disc healing?
Many didn’t even know it COULD heal.
Most herniated discs heal as long as there is nothing to get in the way of the healing process.
That is why I do the (walking) gait evaluation to see if we can see anything in their walking mechanics like abnormal motion of the joints that is aggravating the disc to interfere with the healing. We often times have these Ah-a moments when the patient and I both look at the walking pattern.
Think of all the styles of footwear you wear.
All of them cause a different pattern of motion.
Even the high tech running shoes are often designed with a lift in the toe and a lift in the heel. Think of what that does to your foot and the joints that interconnect to the foot.
My opinion is that the most likely unnatural implement that creates abnormal motion is footwear.
Doctors and scientists can argue with me but do they recommend putting devices on your elbows, knees, neck and spine that attach tightly during exercise? Why should we follow different principles of training and adaptation of the foot than other joints?
That is why I am a barefoot runner. It is my very strong belief that walking and running should be done barefoot whenever possible. If you cannot do it you should strive to achieve this goal. If you could walk and run barefoot as a child you should try to restore the ability to do what you could do as a youth.
I am constantly challenging my body with 700-900 pound impacts on concrete and asphalt surfaces to check to see if my bodies protective mechanisms are still protecting me from the impacts and that my pattern of motion is as close to right as I can get it. Im always working on my form and technique.
Why is it that experts in physics, engineering and even mechanics find this obvious that footwear effects “natural” motion yet doctors feel that the human body is governed by different laws besides those established in physics for 300 years?
If these laws which govern what happens when two objects collide are given then they should be applicable to the human body and the earth colliding. The only difference between mechanical springs and human spring like structures are that mechanical springs do not get stronger with proper use but human spring structures do. We call it positive adaptation.
So when I am striving to help a patient improve walking mechanics to decrease inflammation my goal is barefoot running as the ultimate achievement of a healthy human protective mechanism.
The lessons I want you to learn from this post are:
- The inflammatory process is a necessary process to protect, repair and fight off foreign invaders.
- Chronically high levels of silent, painful, systemic and arthritic inflammation are detrimental to out health
- All sources of inflammation should be considered for a progressive preventive approach to long-term health.
- The area of the most pain is just the area of the highest inflammation and should not be the only area to be evaluated. All interconnecting regions above and below should be evaluated for silently inflamed connective tissue (muscles, ligaments and tendons)
- The body protects itself from impacts with a kind of spring mechanism that can be evaluated with a gait, walking or running evaluation. You can check your walk to see if there are obvious flaws that could be causing abnormal movement patterns that lead to stress and strain on your muscles, tendons and joints that release inflammation. Restoring a more normal walking or running pattern that reduces this stress on your joints can help you fend off higher than normal levels of what I call arthritic inflammation.
I hope you learned from this post as I feel it is central to optimum health!
Dietary and airborne sources of inflammation are another subject that we can write an entire book about. When I post information on this I will add those links to this post.
However, Dr Barry Sears and other doctors and scientists speak of silent inflammation related to inflammation from food you eat or other irritants that may stimulate the release of inflammation. This is commonly referred to as silent, dietary, or systemic inflammation.
Those who are looking at mounting a progressive approach to reducing overall inflammation should make a check list of all POSSIBLE sources of inflammation from arthritic sources (even if you don’t have pain), dietary inflammation (even if you think you have a good diet) airborne sources of inflammation (even if you don’t smoke or use sprays) and other sources of inflammation.
Once you made your list, go to the expert who is most qualified to check for these sources of inflammation and check the boxes off one by one. Then put an intervention strategy to reduce chronic levels of harmful inflammation. Then you need a maintenance plan together to keep inflammation at bay for the rest of your life.
If you would like a more accurate way to assess your levels of inflammation you can get blood tests for it.
- C-reactive Protein
- Arachidonic/Eicosapentanoic Acid Ratio
- Interleukin-6 • Interleukin-10
- Tumor Necrosis Factor-Alpha
This video tutorial was taken from the lecture:
Lecture: Run For Life! Barefoot Presented by Dr James Stoxen DC
The 8th Annual Malaysian Conference And Exhibition On Anti-Aging, Aesthetic And Regenerative Medicine
Kuala Lumpur, Malaysia
April 30 — May 2, 2011