Multiple Sclerosis

Multiple Sclerosis (MS) is a disease of the nervous system, mainly the brain and spinal cord. The nervous system acts as a communications centre, sending and receiving messages to and from the brain. These messages are conveyed as impulses traveling along nerve fibers from the brain through the spinal cord and through the nerves branching off it. Most of these nerve fibers are covered along their length with a substance called myelin. MS attacks the
myelin, causing scarring (sclerosis).

Causes of Multiple Sclerosis
The cause is unknown, but many researchers think that the immune system is in some way involved. There may also be an inherited tendency that increases susceptibility to Multiple Sclerosis. One common theory holds that an unidentified virus, acquired in youth, triggers the immune system to turn against itself. As part of this response, the immune system attacks the body’s own myelin, resulting in MS. The disease is unevenly distributed over the globe, with
a much lower incidence in tropical areas. The critical geographical factor seems to be the area in which people spend the first 15 years of their lives. After this age, their probability of developing the disease corresponds to its incidence in the area they spent their childhood and early adolescence.

Symptoms of MS
Symptoms vary widely, may occur in any order and may disappear for long periods. Among the more common symptoms are:

• Loss of vision in one eye and double vision
• Psychological changes, such as mood swings, apathy and lack of judgment
• Dizziness
• Staggering or loss of balance
• Dragging one or both feet
• Hand tremors
• Facial numbness or pain
• Loss of bladder control leading to increased urinary tract infections
• Speech problems
• Loss of hearing
• Pins and needles sensations in various parts of the body, prickling or numbness
• Increasing disability or paralysis on one side
• Impotence in men

How is MS diagnosed?
MS is difficult to diagnose because the symptoms are so variable and so intermittent. A physical examination may reveal nothing in early stages, and the person’s complaints may be dismissed as imaginary or emotional. Often, diagnosis is by a series of tests to eliminate other possible causes. MS may be confirmed by evoked response testing. This involves recording the speed of electrical response in the brain to an external stimulus, such as a flashing light. The speed of electrical response is usually slowed down in MS because of damage to the myelin sheaths. There is no cure for MS, but attacks can sometimes
be reduced in intensity. Treatment is aimed at relieving symptoms.

The course of MS
While the course of MS is highly varied and unpredictable, in most patients it comes and goes. The disease usually begins between the ages of 20 and 40. The
periods when symptoms disappear are called remissions. At first, months or years of remission may occur between episodes of the disease, but usually the intervals become gradually shorter. Disability is normally progressive and permanent, but the person’s life span is rarely shortened. Some people have frequent attacks and rapidly become incapacitated, while others are able to lead normal lives and continue with their normal job even though they may be
bothered by symptoms at times.

Skin Infections

What are Skin Infections?
Skin infections occur when the skin’s resistance to attack is lowered, or overwhelmed, by micro-organisms. In either case, the infecting organisms reach the layers of the skin under the surface where they can cause inflammation and damage.

What causes Skin Infections?
The epidermis (outer layer of the skin) is highly resistant to infection, but if this barrier is breached by cuts or abrasions, infection becomes more likely. The skin also has its own immune defences, which include immunoglobulins (special proteins which destroy invading organisms). Strong sunlight can weaken these defences, resulting, for example, in cold sores. Some of the more common types of viral skin infections are:

• Chickenpox: this is acquired by inhaling infected droplets expelled during coughing or sneezing. The virus migrates to the skin where it causes crops of tiny irritating, crusting blisters.
• Shingles: This is caused by the chickenpox virus, which has lain dormant in the nerves for years, after an attack of chickenpox. Symptoms include tenderness and hypersensitivity of the skin, blisters, and sometimes, persistent pain.

• Cold sores: These may be transmitted by kissing the lips and face. They form small, tense, painful blisters that cause crusts and then heal in about a week.

• Genital herpes: This is caused by a sexually transmitted strain of the cold-sore virus.

• Warts and veruccas: Viruses cause all these from the human papilloma group.

The more common bacterial infections of the skin include:

• Boils: These result from infection of the skin pores with staphylococcal bacteria, causing small local abscesses with inflammation and pain.
• Impetigo: This causes areas of blistering, weeping and yellow crusts that may be wide spread. It is most common in children.
• Cellulitis: This occurs where streptococcal infection of the skin has lead to a rapidly spreading inflammation and accompanying fever. It can be dangerous if it progresses to septicaemia (blood poisoning).

The following represent the more common fungal skin infections.

• Tinea: This group includes tinea pedis (athlete’s foot), tinea corporis (body tinea), tinea cruis (crutch or jock itch), and tinea capitis (head tinea).

Tinea can be caught by direct contact with an infected person or animal, or directly via infected objects such as towels and changing room floors.

• Thrush: Known as candidiasis, its cause is the fungus Candida albicans. Mucous membranes such as the mouth or vagina are usually affected, but it readily spreads to moist areas of the skin causing an itchy red rash with white patches on it.

• Pityriasis versiclor: This is a superficial fungal infection mainly affecting the trunk. Either increased or decreased pigmented patches appear on the skin and patients may notice that they do not tan properly in the affected area.

Symptoms:
• Local redness
• Blisters that may crust or flake
• Irritation
• Pain
• Inflammation
• Fever
• Malaise

Insomnia

Insomnia is a term used to describe interference with normal sleep patterns. Symptoms include delays in falling asleep, waking during the night but eventually going back to sleep, or waking very early in the morning before the sleep cycle has been completed. Quite often, insomnia is more a perception of sleeplessness than true disturbed sleep. This may be due to disordered sleep patterns or sleep that is so fitful that you wake feeling out of sor ts and tired.

What causes Insomnia?
Everyone occasionally experiences some difficulty sleeping, and sleeping patterns tend to change with age – many older people find they need fewer hours of sleep. Gradually, however, insomnia falls into one of two categories – primary, with no apparent physical or environmental cause and secondary, where a cause can be identified.

Secondary insomnia can be further classified as transient, short term or long term. Transient insomnia lasts for only a few nights and may be due to stress, worry, illness, noise, an itchy rash or some other reason. Short-term insomnia lasts up to 3 weeks, and a cause, either physical or emotional, can usually be found.

Long-term insomnia may be due to environmental factors, such as living in a noisy area. Long-term insomnia can go on indefinitely, unless the cause can be identified and treated. More often, however, it is the result of medical conditions such as heart disease, arthritis, diabetes, asthma, chronic sinusitis, epilepsy, a peptic ulcer or any painful condition such as backache.

Insomnia can also be brought on by chronic drug or alcohol use, excessive caffeine intake, or the abuse of sleeping pills. Psychiatric conditions, such as depression or stress can also cause long-term insomnia.

Hernia

An abdominal hernia occurs when a portion of an internal organ (usually the intestine) bulges through a weakened segment of the abdominal muscle wall. A layered sheath of muscle that normally keeps the internal organs firmly in place covers the abdominal cavity. If a segment of this muscle wall becomes weak or slack, a portion of an underlying organ can protrude through. This can occur without the sufferer even knowing he or she has a hernia; but generally sufferers notice a bulge at the site of the weakness. Hernias can occur anywhere in the body but are most common in the abdominal area.

Specific types of hernias include:
• Epigastric hernia. This occurs in the upper abdomen, between the breastbone (sternum) and the navel. It is more common in men than women, and can cause tenderness in the area, indigestion, belching and sometimes vomiting.

• Para-umbilical hernia. This develops around the navel and is more common in women than in men. It can produce constipation and sometimes abdominal pain.

• Inguinal hernia. This occurs in the groin area, and is generally found in men or male babies.

• Femoral hernia. This is similar to an inguinal hernia, except it is lower in the groin. It is most common in women who are overweight or have had several children.

• Umbilical hernia. This occurs in newborn babies and appears as a bulge at the navel.

• Incisional hernia. This occurs after abdominal surgery, at the site where the muscle was cut.

Causes of an Abdominal Hernia
Hernias are caused by weakening or a tear in the muscle wall that covers the abdominal cavity. Pregnancy, surgery and obesity can be precipitating factors. Some hernias occur suddenly, for example, when you cough or strain to lift a heavy object. Others will evolve over a few days or even weeks. The weakness in the muscle wall may have been present since birth. Generally, a hernia will become progressively worse as time goes on.

Neck Pain

A Pain in Your Neck

From stiffness to aches – pains in the neck are all too common. No wonder: your neck is prone to injury from poor posture, years of abuse, wear and tear, and even stress. Joints can be pushed out of alignment, and other structures can be stretched, distorted or torn. Using specialised
Traditional Chinese Medical (TCM) approaches, stiffness and instability, as well as joint, nerve, and other neck problems can be rectified.

Know Your Neck

Your neck (cervical spine) is made up of the top seven vertebrae of your spine. A healthy neck is strong, flexible, and pain free, and the joints of these vertebrae are balanced and aligned with a natural curve. Your neck supports your head, protects your spinal cord and spinal nerves, and allows you
to move your head in a variety of ways.

A Balanced Spine

Vertebrae and Discs
Your neck is made up of seven bones. Vertebrae are naturally aligned in a slight forward curve. The vertebrae have openings (Foramina) where the cervical
nerves pass into the shoulders and arms. Discs are shock absorbing pads of cartilage between the vertebrae. Healthy discs have a tough covering, a jelly-like interior, and a certain amount of “give” to adapt to various head and neck movements.

Joints
The joints in your neck allow you to move your head. Each vertebrae joins with the next in two places (the facet joint and the Joints of Luschka), giving the spine great flexibility.

Nerves
Your neck is the channel connecting your brain with the nerves throughout your body. Spinal nerves branch off from the spinal cords and pass through the foramina. Each spinal nerve is “rooted” to the spinal cord with two small nerve roots.

Soft Tissue
Soft tissue includes muscle, tendons, and ligaments. Muscles work together to move and support your head. Tendons are tough tissues connecting muscle to bone. Ligaments are strong bands of tissue that stabilise and connect vertebrae. Trigger points are small, localised areas of pain and muscle spasm, a common symptom of many neck problems. Referred points may originate in the neck but can be felt nearby in the shoulders, arms, and hands or face. Each
muscle has its own pattern of referred pain.

Your Range of Motion
Your neck moves more than any other part of your spine, and can move in three basic ways. Each of these movements has its own range of motion – the amount of motion that is normally possible. Most neck problems affect your range of movement in some way. Flexion is dropping your head forward; extension is dropping your head backward. Their combined range of movement is about 90 degrees. Rotation is turning your head from side to side, and has
a range of motion of about 180 degrees. Tilting your head from side to side has a range of motion of about 120 degrees.

COMMON NECK CONDITIONS

Neck Stiffness (hypomobility)
Can result from poor posture, muscle tension, stress, and fatigue. When your neck has too little mobility, you may experience stiffness, pain, muscle tension, and muscle tension headache. If you have a stiff neck, you may also have pain and muscle spasm, an aching, tired neck, headache, and referred pain to your face, shoulder, arm, or hand. Stiffness can come on suddenly, or can accumulate fatigue and stress over many years. Left untreated, stiffness may result in muscle tension headaches and eventually lead to the degeneration of your joints (osteoarthritis).

Instability (hypermobility)
If your neck problem is instability, you may be feeling pain, muscle spasm, and the curious sensation of a wobbly neck. Instability is often caused by a whiplash injury from a car accident. Your head is hurled in one direction, then another, causing the ligaments, muscles and tendons of your neck to stretch too far or tear. (You may have had the injury several years ago, with neck pain and looseness ever since.) Left untreated, instability can result in stiff scar tissue around your joints, referred pain, headache, and disc problems.

Degenerative Joint Disease
When a spinal joint becomes misaligned or injured, the vertebrae can’t move properly, discs can become compressed, and nerves may be irritated. As degeneration progresses, your discs lose their ability to cushion and your vertebrae can develop bone spurs.You may experience pain, stiffness, headaches and nagging neck aches (often worse in the mornings). Joint degeneration is often the result of too much stress on the joints caused by poor posture, repeated movements, or injury. Left untreated joint problems can begin to affect your nerves and spinal cord.

Nerve Root Problems
With nerve root problems, the spinal nerves that pass through the vertebrae in your neck can be stretched, inflamed or pinched.You may experience sharp pain shooting down your arm (often triggered by turning your head), or tingling, weakness, and numbness in your arms and hands. A nerve root problem can be caused by a variety of joint and disc problems, such as facet problems, a ruptured (herniated) disc, or severe osteoarthritis. Left untreated further neck or nerve problems can develop.

NECK EXERCISES

Your TCM practitioner may recommend that you do some of the exercises below (or offer you others) to increase flexibility and strengthen your neck muscles. These exercises can help you maintain the improvements gained through your treatment regime, as well as help prevent future neck problems. Ask how often each exercise should be repeated. Do them slowly, and try to relax and breathe naturally. Before beginning your exercise program, consult your TCM practitioner. Discontinue any exercise that causes pain and discomfort, and check with your TCM practitioner.

Shingles

What are Shingles?
Shingles is a viral disorder that appears as a rash, patch, or a line of painful blisters, which arise on the skin over a nerve. The rash often forms a girdle-like belt over the skin area served by a single nerve. In fact, the name shingles is derived from the Latin word cingulus, which means belt or girdle. The disorder frequently appears on a strip of skin over the ribs on one side of the body, on the side of the neck or arm, or on the upper half of the face. Shingles can cause
prolonged pain, particularly in older people or those that are weakened by other diseases that affect the immune system. Discomfort can last long after the characteristic rash has disappeared.

Symptoms
• Excessive sensitivity of one area of the skin, followed by pain and irritation.
• After around 48-72 hours a rash appears, first as slightly raised red spots, then as swollen red blisters.
• Blisters slowly dry out, flatten and crust over. Small-pitted scars may be left after the rash has disappeared.
• Pain can persist for months or even years after the rash has cleared.

What causes Shingles?
The virus called herpes zoster causes the skin eruptions of shingles. This is the same virus that causes the common childhood illness chickenpox. Shingles is most common in people over the age of 50. The medical belief is that after a youngster recovers from chickenpox, some of the virus hides, in an inactive state, in the nerve cells. They may then re-emerge years later – perhaps when the body has been awakened by another illness or stress – to cause shingles.
Virus particles can be found in the skin lesions. But the nerve track and adjacent lymph nodes are also swollen and inflamed, and thus may contribute to the pain.

Tinnitus

Tinnitus is a perception of a sound in the ears or head when no external sound source is actually present. The sound is usually of ringing, but it may also be a buzzing, roaring, whistling or hissing noise. It may also vary in its quality and intensity at different times. It is very common, affecting up to one in six of the adult population. Those with normal hearing as well as the deaf or hard of hearing may be affected.

Causes of Tinnitus
There are a number of situations, which can cause damage, or over stimulation of tiny hair cells in the inner ear. This results in an irregular series of nerve impulses being sent to the brain, which are then perceived as tinnitus. Major reasons for this occurring are hearing disorders associated with aging, and exposure to loud noise. The condition can also develop following an emotional upset or an illness, injury or infection, which may or may not be related to the hearing mechanism. Tinnitus can also appear as a side effect of or reaction to some types of drugs.

How is Tinnitus is diagnosed?
Many causes of tinnitus are already solved by simply cleaning out the ear. It may be that you need to stop taking, or reduce intake of, certain drugs, such as aspirin or quinine. Although damaged inner hair cells cannot be replaced; it is usually possible to reduce the distress caused by tinnitus.

Ulcerative Colitus

Ulcerative Colitis is a chronic disease causing inflammation and sores (ulcers) on the inner lining of the colon (main part of the large intestine). Although any age may be affected, it usually begins between the ages of 16-25 years, and is equally common among women and men. Sometimes there is a family history of the disease, and this indicates an increased risk of developing colon cancer.

Causes of Ulcerative Colitis
The cause of Ulcerative Colitis is not known. Some scientists believe that the inflammation of the colon is a reaction caused by the body’s immune system turning against itself. Instead of protecting its own tissues, it destroys or damages them. The disease usually begins slowly, but the initial acute attack, or a flare-up, may occur without warning. About 10% of those affected by ulcerative colitis recover completely and suffer no re-occurrence. For the remainder,
the disease is chronic, with a pattern of intermittent flare-ups followed by remission.

How is Ulcerative Colitis diagnosed?
There is no single test to identify ulcerative colitis. Techniques used include sigmoidoscopy, an examination in
which a hollow tube with lighting devices is inserted into the rectum, via the anus. A barium enema (X-ray with radioopaque liquid introduced via the anus) may be carried out, but not usually during a flare-up, since there is a danger of perforating the intestinal wall. A biopsy (removal of a tissue sample for laboratory examination) may be preformed from the colon to rule out Crohn’s disease, a chronic inflammatory disease that may effect any portion of the
digestive tract.

Symptoms of Ulcerative Colitis
• Bloody diarrhoea
• Frequent, loose stools containing blood and pus
• Abdominal pain
• Fever
• Loss of appetite and weight
• Malaise (tiredness)

Breathlessness

Breathlessness is the need to breathe air in and out of the lungs quickly. This is normal during strenuous exercise, as the lungs must work harder to supply the muscles with extra oxygen. When breathlessness occurs at other times, the difficulty in breathing is likely to be due to a disorder. The problem may be an obstruction of normal airflow through the lungs by the blood, or damage to the breathing center at the base of the brain.

Asthma
Breathlessness is a common symptom of asthma, along with wheezing and a recurrent cough. Allergies, stress, odors, cold air, exercise and many other factors can trigger an asthma attack.

Blood Disorders
The blood carries oxygen to all the cells in the body. Anemia and other blood disorders, such as leukemia, can cause breathlessness because the blood becomes less efficient at absorbing oxygen and transporting it around the body.

Cancer
Increasingly difficult and painful breathing usually accompanied by chronic coughing and perhaps spitting up blood-flecked phlegm are possible signs of lung cancer, especially amongst smokers.

Collapsed Lung
A collapsed lung (pneumothorax) occurs when air gets into the space separating the two layers that surround the lung (pleura). A sharp pain in the chest, followed by severe shortness of breath and pain when inhaling, suggest a collapsed lung. This may follow an injury to the chest, which pushes a rib down into a lung. However, it can happen spontaneously due to weakness in the pleura.

Emphysema
Here, the lungs’ tiny air sacs (alveoli) break down to form larger spaces so that the area of membrane available for oxygen transfer is reduced. Emphysema cannot be cured, but there are a number of treatments that can help relieve the symptoms. Smoking frequently causes emphysema.

Heart Disease
Shortness of breath can result if the heart is unable to pump enough blood to supply the oxygen needed by the tissues. If this is accompanied by severe chest pain, sweating and nausea, a heart attack may be taking place. Waking at night with shortness of breath may be a sign of heart failure and can usually be eased by sleeping in a more upright position.

Hyperventilation
Anxiety, panic attacks, or stress can result in abnormal deep or rapid breathing (hyperventilation) and a feeling of suffocation.

Excess Weight & Lack of Fitness
Breathlessness during minimal exertion is usually due to having to carry excessive weight and to lack of fitness. Most obese people conform to this pattern of symptoms.

Pleurisy and pleural effusion
Pleurisy is irritation and inflammation of the pleura, the double-layered membrane surrounding the lungs. It can be caused by an infection, such as bronchitis, or rarely, by cancer. Pleural effusion is seepage of fluid into the space between the membranes. Pleurisy makes breathing painful. The pain is
characteristically sharp and occurs when a person breathes in. A pleural effusion compresses the lung, and makes it less efficient because it can no longer expand fully.

Pneumonia
Difficult or painful breathing, accompanied by fever and coughing up thick greenish or rusty colored phlegm suggest possible pneumonia.

Upper Respiratory Infections
Any infection in the air passages behind the nose and throat leading down into the windpipe (trachea) can make breathing difficult. The infection causes inflammation of the lining of these upper airways, leading to swelling and increased production of mucus. Both these effects can obstruct the flow of air. In young children the windpipe is narrower so that swelling of the lining may need emergency treatment to prevent it from completely blocking the airway.

Headaches

Headaches are a common pain. It can happen at any age and can often be the result of your lifestyle.There are several common types of headache as follows:

Tension Headache
Stress, worry and anxiety can cause pain at the back of your neck or across the top of your forehead. It can feel like a band around your head or a weight on top of your head. Working in the same position for many hours each day may make a tension headache worse and last longer.

Migraine
Migraine pain commonly occurs on one side of the head and when severe, may throb in time with your pulse. If your headache is a migraine, you may not be able to bear light, noise or strong smells.You may also feel sick and sometimes vomit. Some people may have warning signs before a migraine starts, such as flashing lights or numbness and tingling in their arms, legs or face.

Cluster Headache
Severe pain occurs behind one eye or on one half of the head, with redness and watering of the eye and blockage of the nostril on that side. It can last for 10 minutes to two hours and may occur again several times in 24 hours, often waking the person from sleep.These headaches can occur in bouts, usually lasting for weeks or months and are separated by pain free periods of months or years.

Sinus Headache
Blocked sinuses cause pain above the eyebrows, between the eyes and in the cheekbones. The pain is worse when waking up or bending over.

Causes of Headache
Some people find that certain things trigger their headaches. Triggers aren’t the same for everyone and they can be different for the same person at different times.

Triggers include:
• Stress, tension
• Hormonal changes eg. periods, pregnancy, the oral contraceptive pill, hormone replacement therapy
• Coffee withdrawal
• Too much alcohol
• Fasting, missing meals
• Too little or too much sleep
• Glare or cold, windy weather
• Some medicines
• Stuffy, smoke filled rooms.

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