Sports Medicine/Chronic pain

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Question
Dear Dr. Patricia B. Arthur,

I have been suffering from chronic pain since 2008. I don't know what brought it on, I just remember waking up one morning and was in severe pain (there was no big event like an accident or anything). Every morning (and throughout the night) I wake up with pain in my lower (floating) ribs on my left side. The pain is worst when I breathe. I feel it in my back, around the lower two ribs. I have to massage my back just under the ribs to make the pain subside enough for me to be able to breathe. I also feel a clicking sometimes when I cough or laugh. It affects my every day activities and I am unable to do a lot of things (e.g. dancing, sports etc) due to the pain.

I have had x-rays, ultrasounds, and bone scans which have all shown nothing. I have been to a chiropractor, physiotherapist, osteo, had deep tissue massage, dry needling, acupuncture, steroid injections, and even a spinal block injection to stop the pain (which only lasted for one day).

I sit, stand, and lie down in certain ways to try avoid the pain and it is having an effect on the rest of my body. I am now noticing a new set of issues, such as back pain, neck pain, headaches, etc which I think are related to my posture.

No doctor has been able to tell me what the issue is or make any difference to the pain (it is still the same as it was in 2008).

Answer
Hello Claire!

Actually, after reading your letter, I can't believe any physician has overlooked Fibromyalgia!  It seems you have a classic case of this malady, and the medical journals have written extensively about the diagnosis of this entity.

There are certain diagnostic studies that can be performed to delineate this problem, and to make a positive impact on the life of the patients.  Please look for a physician in your area that specializes in Fibromyalgia, or you might want to see a Neurologist who has some experience with Fibromyalgia .  I'm sorry you have been through so much in 6 years, but if you are able to find a qualified specialist, you will start to feel much better, finally.

Please let me know what you are doing, and how you are feeling.  I really am sad that this has taken so long, and I want you to know I care what happens.

Sincerely,

Dr Patricia Arthur

Sports Medicine

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Dr. Patricia B. Arthur, DC, MRC, CST

Expertise

As a 30-year practicing Chiropractic Physician, my specialty was Sports Medicine. For 8 years I had the distinct pleasure of working with the USOC, and traveled the world to care for the athletes in the Pre-Olympic venues for the Summer Games. When I wasn't traveling, I had a private practice, and a hospital practice, in Kamuela, Hawai'i. Questions I couldn't answer usually dealt with pharmeceuticals. This was not my expertise, but the simple questions pertaining to familiar drugs I was able to digress, or refer to someone that was knowledgable in that field. Most Sports Medicine field injuries were familiar to me, but I always aired on the side of caution. In my office practice, I would tend to see more patients with the weekend injuries who would try to self-treat, only making the injury worse than it should have been! Nevertheless, I never took anything for granted, and so it was my conservative approach to the "cause-and-effect" mechanisms that were vitally important to the healing process.

Experience

Following my competitive nature, I knew Sports Medicine would always be a part of my life. After graduation from Palmer University in Iowa, the old adage taught at the school dealt only with the spinal column......anything connected to the spine was outside our scope of practice. To me, this was too simplistic, because the complex body also had arms and legs! From this point, I developed specific technigues which would encorporate the body as a whole rather than haphazard segments. There is nothing traumatic that happens to a single ligament, tendon or joint that doesn't effect a secondary, or possibly a tertiary element in that area. In order for that space to heal, all the factors must be addressed. Volunteering my time teaching referrees, coaches, and interested parents about the realities of probable sports injuries was worth a thousand words!j

Organizations
American Chiropractic Association; Local Emergency Response Committee; Hazardous Materials Response Team; Urban Search and Rescue Team - Operations and Planning; Federal Corps of Engineers Committee; Earthquake Advisory Board; Big Island Wildfire Committee

Publications
Papers published focusing on the importance of proper care of sports injuries; Authored medical columns for the syndicated magazine "The People's Doctor "; Published papers in professional journals on Head Injuries in Sports; Published papers on Drug Abuse in Sports.

Education/Credentials
Robert Packer Hospital - Certified Surgical Technician - CST; Palmer University - Doctor of Chiropractic - D.C.; Wright State University - Masters in Counseling/Psychology; Wright State University - Masters In Couseling of the Severely Disabled.

Awards and Honors
Selected US Olympic Physician -1988; Graduated Wright State University with a 3.75 GPA; Graduated Palmer University with a 3.5 GPA; Faculty Appointment - Palmer University Post Graduate Education; Faculty Appointment- Hawai'i/Kapiolani Community College - Skills Team Tester;

Past/Present Clients
Cincinnati Bengals Football Team pre-season training; Summer Olympic Athletes worldwide; Kona Ironman Triathletes - Finish - line physician

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