Posterior Tibial Tendinitis
Robert Filice, M.D.
I saw a 78 year old woman patient for knee
Prolotherapy recently, and her
case is very instructive, so I want to share it with you.
I saw her initially 3 years ago for Posterior Tibial Tendinitis pain.
This is an inflammation of the tendon of the posterior tibialis muscle
which runs across and behind the inner ankle bone. The muscle helps
stabilize the ankle and moves the foot down (as in stepping on the gas)
and inwards. Before she came to
Caring Medical she consulted a Board
Certified orthopedic specialist. He made the diagnosis by clinical
examination alone, recommended and later applied a boot for
immobilization
(which probably just made matters worse by weakening auxiliary support
structures around the ankle), and then proceeded to tell her that she
would have to "learn to live with it". He said he could perform surgery,
and that "the surgery would be a success", but that she probably would
experience no change in her symptoms. One would wonder under what
circumstances someone might agree to having that type of surgery
performed! But from what he told her, it was clear that he knew that she
was not a candidate for surgery. But what about suggesting other
available treatments? He didn't recommend
anti-inflammatories,
he didn't recommend ultrasound, he didn't recommend physical therapy,
heat, ice, etc etc. He didn't even recommend the Holy Grail of most
orthopedists' presurgery practices...the
cortisone
shot!
This remarkable lack of even a minimalistic attempt to manage, treat,
and help his patient is outstanding in its deficiency. The only attitude
that could explain such a management style is that this physician only
is interested in doing surgery. I wonder if that might have to do with
the bigger
insurance checks that come from those procedures? But at
least to his credit on this one item, he knew surgery was not going to
work. But then, he left the patient cold. He basically dropped her,
implying that "if I can't operate on you, I'm not interested in trying
to help you at all." Isn't that amazing? Isn't that scary? I will tell
you that unfortunately, such events are not at all rare. I must warn my
readers to be very concerned about encountering this type of
practitioner in their search for help. This person is not a healer or a
physician. It sounds to me like he's a surgical technician with only one
thing in mind...enhancing his financial bottom line.
What happened with this case once she came to Caring Medical?
I examined her and confirmed the diagnosis of posterior tibial
tendinitis. I recommended Prolotherapy and offered her a very hopeful
prognosis. She diligently returned monthly for 5 months, receiving a
Prolotherapy treatment each time. With each visit she showed more
improvement in her pain. When she came back to start treating her knees
two months ago, I hadn't seen her in almost 3 years. Why? Because
her posterior tibial tendinitis completely and permanently cleared up
with Prolotherapy. Today I did her 3rd treatment on her right knee, and
she was already completely free of knee pain except when walking up
stairs. She rated her global improvement at 50% after just the two
treatments. This case, like so many of our cases here at Caring Medical
speaks for itself. It requires no hype or embellishment. Prolotherapy is
an awesome treatment for musculoskeletal pain.
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