piriformis syndrome, chronic pain, and chronic disease: a case history

PIRIFORMIS SYNDROME: A CASE HISTORY

Obesity Solutions

Lately, I’ve been taking something someone sends me and answering it via a blog post for everyone to share (HERE are some others).  As in many cases, I feel this individual (“Linda”) may be holding the key to dramatic improvement in her hand.  Even though her question was filed under a post on PIRIFORMIS SYNDROME over at my DESTROY CHRONIC PAIN site, I highly doubt Linda actually has PS.

Hello Dr.

I am a 52 year old overweight female with many health issues. I just had foot surgery, but what is pressing me at the moment is constant nagging dull aching pain right on and around my tailbone. I do have Degenerative Disc Disease, and I think a bulging disc in my lower back. I also am type 2 diabetic, and have Fibromyalgia, Rheumatoid Arthritis, and Interstitial Cystitis. I also have Asthma, and Chronic Obstructive Pulmonary Disease. When I am able to walk I felt better but didn’t lose more than 5 pounds. I eat well also.

Sincerely, Linda

Hello Linda, Of the health issues you specifically mention, I can classify all of them into two groups, CHRONIC INFLAMMATORY DEGENERATIVE DISEASES and AUTOIMMUNE DISEASES.  Those in the first category would include ASTHMA and COPD (the first making it difficult to inhale, the second making it difficult to exhale), DDD / DJD, DISC HERNIATION, OVERWEIGHT / OBESITY, and TYPE II DIABETES.  The second group on this list (Autoimmunity) contains RA and INTERSTITIAL CYSTITIS. FIBROMYALGIA (a form of ADRENAL FATIGUE) is a wash, with some believing it to be autoimmune and others not (I believe it probably is).  Although it’s certainly not the most important feature in this lot, I’m going to focus on the weight issue for a moment.

Just yesterday an article about a brand new study from Obesity Reviews was published on LiveScience (There are At Least 79 Obesity Syndromes).  To show just how big a deal this issue of “Genetic Obesity” really is, the author stated, “Although lifestyle factors, such as diet and physical activity, play major roles in obesity, research has shown that there’s a genetic component of obesity as well.  They [researchers] looked through more than 160 studies on genetic forms of obesity [and] identified a total of 79 genetic “obesity syndromes,” meaning conditions that result from a genetic change and cause a person to be obese…”  According to these experts, “Obesity is estimated to be between 40 and 75 percent genetic….” While this is great news for those who love COP OUTS, I have real reservations of swallowing this study, hook, line, and sinker. 

Firstly, we know that everyone reading this carries a plethora of genes related to sickness and disease. The beautiful thing is, most of these diseases are never expressed because these genes are never turned on.  That’s right; diseases are not nearly as caused by the genetic coding itself, as by whether or not the harmful gene is actually triggered.  This, folks, is the field of EPIGENETICS, and is in most cases, a far bigger deal to your health than the field of Genetics. Secondly, most of these syndromes are rare, with the author admitting that, “Indeed, these syndromes are quite rare, with their prevalence ranging from 1 in 565 people to less than 1 in 1 million people.

Thirdly, the numbers don’t add up.  With nearly 2/3 of our population being overweight or obese, and just under an additional 10% more being MONW (“SKINNY FAT“), the genetic factor fails to account for a huge percentage of people carrying excess weight.  This issue becomes even more glaring in light of the fact that just a few generations ago, obesity was as rare as it is now common.  Yes, there are some people who have “genetic” obesity.  But for scientists to claim that half to three quarters of all obesity fall into this category is not telling the whole story.  And lastly, let’s be honest with ourselves for a moment.  If you are, in fact, one of the those individuals whose weight issue really is genetic, what’s your doctor going to be able to do for you anyway?  THIS?  Protocols like mine offer the best chance of getting off the MEDICAL MERRY-GO-ROUND and staying off.

When Linda says she “eats well,” she‘s probably telling the truth — at least in her mind.  I see lots of people who are STUCK IN THE 1980’s when it comes to their diets (HERE).  I see this scenario routinely; people who are so adamant that they are doing things right that it’s almost impossible to get through to them other than provide them a copy of my CLINIC’S CHECKLIST and hope they actually sit down, read, and figure it out on their own.  For the person who simply can’t lose weight no matter what, I would make sure there’s not an OCCULT THYROID PROBLEM in the picture.  The next step is to do an ELIMINATION DIET to find out what might be driving some of their SYSTEMIC INFLAMMATION, then probably try a KETOGENIC DIET to really hit both the blood sugar and the weight.  Just remember that the blood sugar issues drive almost everything (HERE).

Someone with this much Systemic Sickness is at the doctor a lot — probably not just for said illnesses, but to address COLDS, FLU, SINUS INFECTIONS, etc.    Unfortunately, this is almost always done using ANTIBIOTICS, which further weaken the immune system.  People with Autoimmunity cannot afford to weaken their immune systems.  Attenuate; YES.  Weaken; NO.  Because of this, I would suggest that at the very least, Linda study the issue of FMT.   And although I feel that exercise is not nearly as critical as other things in her recovery process, since she feels better when she does, she needs to find some things she can do and do them, whatever those may be — water aerobics, recumbent bike, Tai Chi, Yoga, etc, etc.

It’s no surprise that the drugs haven’t been getting it done for you Linda (HERE).  Study and create yourself an EXIT STRATEGY — write everything down and keep it simple enough that you can stick with it.  Although breaking your SUGAR ADDICTION will be tough (the combination of female, fibro, diabetes, and autoimmunity is a dead give away), you can’t get better unless you successfully address this issue.  Work your plan for six months.  If you are seeing good changes, great.  Continue.  If you are not, find someone in your area who specializes in FUNCTIONAL MEDICINE and at least do a consult to see what they have to offer.  Oh; make sure to read our other Case Histories as well.  Sincerely, Dr. Russ.

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