Question:
I desperately need help, so I'm asking everyone I can think of who may have insight into why the body "goes south" despite a person's best efforts to secure great health. Please bear with me as I elaborate:

In June 2000, I began experiencing tightness and a
grating sensation in my right knee. It became
noticeable whenever I clipped into my pedals and went
for a bike ride. My right knee would always pop once,
then felt like it was "twisted" in the pedal, from my
right hip, through the knee, and down to my right
ankle and foot (big toe joint). My left leg always
felt flexible and strong.

Over the years, the tightness progressed, and spread
to my right hip, right ankle, right heel, lower back,
upper back, tightness in my left buttock/hamstring
area, and right shoulder, back of the left ankle, and
the bottom portion of the front of my left knee. I
also have sharp pain under my right heel.

I've tried things such as, chiropractors, natural and
pharmaceutical supplements, orthotics, different
stretches, changing my diet from vegan-vegetarian to
meat and back to vegetarian, fasting, and different
shoes. I've been active with swimming, cycling,
running, strength training, and yoga. I've
experimented by laying off these activities (been off
the bike for 4 months) to see what would happen. I
didn't feel the stiffness, tightness, and sharp pain
in these areas diminish. These symptoms are always
present when do have to walk in order to complete my
errands. I'm stiff in my feet, knees, lower and upper
back when I get up in the morning. It loosens up when
I expose these areas to cold water; but, after the
numbness from the cold wears off, I have the symptoms
again.

I've had X-rays of my feet, knees, and hips. I've also
had an MRI of my lower back. The physicians (one was
orthopedic) did find some "joint mice" in the right
hip. One chiropractor here in South Western, WA
looked at an X-ray of my pelvic area and noted that my
pelvis is twisted. There is also an area in the L5
region where the vertebrae did not join. He theorized
a birth defect (Spina Bifida). He said he's seen this
defect before and it shouldn't cause the problems I'm
experiencing now. Even though I'm exploring other
opinions, it's true that I didn't have these problems
for most of my life; it just gradually became a
problem five years ago.

On July 11, 2005, after I got out of the shower, my
lower back on the left side "seized up." I couldn't
bend over or sit down. It became more manageable the
next day, but it hasn't felt the same since.

On July 20, 2005, while stretching my hands toward the
ceiling, I felt a pinched sensation under my right
shoulder blade; it felt painful and stiff whenever I
tried to twist to the right (like when I would reach
behind to the right to grab something).

The following is a list of symptoms that may or may
not have any connection to what I'm going through now
(I thought they might be relevant).

In 1988, I developed a yeast infection that lasted a
couple of years (mostly noticeable in the groin area).

In 1989, I had mononucleosis; the symptoms lasted
several weeks.

When I changed my diet too rapidly in 1991 (going from
high-sugary, processed foods to more whole grain,
natural foods), I went through 12 years of
on-again-off-again bingeing on sugary carbohydrate
foods.

In 1991, I went over the handlebars on my mountain
bike and landed on the side of my head and right
shoulder.

In 1992, my left foot (first metatarsal) was broken
when an aircraft barrier fell on it.

In 1994, I went to a chiropractor because I felt a
pinched sensation under my left shoulder blade. I
noticed that my left shoulder was noticeably lower
than my right.

In 1997, while mountain biking through a icy section
on a dirt road, I fell off the bike and landed on my
left hip and left shoulder.

I know my body is calling out for help through these
symptoms; I just haven't discovered exactly what it is
my body needs in order to heal. I'm firmly committed
to finding the root to this obstacle and overcome it.
I know it will happen...there are just options I still
need to investigate.

I would welcome any thoughts you may have on this
matter.

SCOTT

Answer:
Hey Guest (Scott), how are you doing?

You may hear a snapping sound as the tendon returns to its original position, after the joint has moved, and the tendon’s position changes and moves slightly out of place. Scientists explain that synovial fluid present in your joints acts as a lubricant and the fluid contains gases oxygen, nitrogen, and carbon dioxide - when you pop or crack a joint, you stretch the joint capsule, gas is rapidly released, which forms bubbles - In order to crack the same knuckle again, you have to wait until the gases return to the synovial fluid. (The Library of Congress What causes the noise when you crack a joint?)

The joint cartilage, subchondral bone, and joint capsule dissipate the forces of weight bearing and function. The joint cartilage has unique properties of compressibility and elasticity due to the combined presence of collagen fibers and proteoglycans. (Mannik, Gilliland 2071)

The aricualr cartilage contains a unique type of collagen, called type II collagen, which is comprised of three identical a1(II) polypeptide chains. Collagen fibers provide cartilage with structural integrity. (Mannik, Gilliland 2071)

The proteoglycans of cartilage consist of a protein backbone and many glycosaminoglycan side chains with negative charges. These proteoglycans molecules bind a large number of water molecules. (Mannik, Gilliland 2071)

Upon compression of cartilage the structural water is released from the proteoglycans and regained upon removal of the compressive force. The loss of compressibility of cartilage secondary to proteoglycan malfunction seems to be a central feature in the development of Degenerative Joint Disease (DJD). (Mannik, Gilliland 2071)

DJD is characterized by loss of joint cartilage and by hypertrophy of bone. In young persons changes identical to the degenerative changes in advanced age are encountered when cartilage has been damaged by injury, infection, or congenital deformities. (Mannik, Gilliland 2071)

Many persons with radiographic changes, however, have no musculoskeletal complaints. The cardinal complaint in DJD is pain, described as aching, confined to joints, especially on motion and weight bearing. (Mannik, Gilliland 2071)

Patients complain of stiffness; this occurs after resting and subsides in a few minutes upon resuming motion. In the morning the stiffness lasts only a short time, whereas the morning stiffness of rheumatoid arthritis lasts an hour or more. (Mannik, Gilliland 2072)

DJD of the wrists, elbow, and shoulders is relatively uncommon. However, occupational trauma may enhance DJD in elbows and shoulders, as in air-hammer workers. (Mannik, Gilliland 2072)

Occupational or sports injuries are frequent causes of degenerative changes in the knees. Torn menisci and ligamentous instability contribute to early changes. (Mannik, Gilliland 2072)

Tenderness, limitation of motion by pain, crepitation, and joint effusions may be present. Chondromalacia patelle produces softening and loss of cartilage from the articular surface of the patella, usually in the early stages of DJD but at times is seen in young patients. (Mannik, Gilliland 2072)

Extensive DJD is found late in the course of acromegaly (giantism). The early articular changes in acromegaly include thickened synovial tissue and conciderable overgrowth of the joint cartilage, presumably in response to the excessive secretion of growth hormone. (Mannik, Gilliland 2073)

The usual laboratory tests show no abnormalities in DJD. Radiologic changes are most helpful. (Mannik, Gilliland 2073)

As a reassurance, DJD is not a diaease with total disability. Steps should be taken to eliminate excessive and recurrent trauma.

A weight-reduction program should be initiated for over weight indivisuals, but for others, only moderate excercise is recommended. Vigorous activity that produce prolonged pain and discomfort should be avoided. (Mannik, Gilliland 2073)

Local heat is useful in many patients with mild DJD. In severe joint involvement, physical therapy with infrared heat, ultrasound, or hot packs may help relieve pain. (Mannik, Gilliland 2073)

DJD of the hip is perhaps the most disabling form of the illness, with conciredable loss of function in the advanced stages. Groin pain, at times referred to the knee, and loss of range of motion are inportant findings. (Mannik, Gilliland 2073)

Secondary DJD of the hip and other joints occurs earlier and often unilateral (occurring on, performed on, or affecting one side of the body or one of its parts). The causes of secondary DJD of the hip and other joints include trauma, fractures, infection, and damage byinflammatory joint disease such as rheumatoid arthritis. (Mannik, Gilliland 2072)

Outstanding results have been achieved with total hip replacement in patients who were disabled by DJD of the hips. Other artifical joints are being developed. (Mannik, Gilliland 2073)

Call your doctor if you experience confusion regarding the diagnosis. (Valley When to Seek Medical Care) Epidemiologic studies suggest that wear-and-tear processes play a central role in initating the degererative process in cartilage. (Mannik, Gilliland 2071)

REFERENCES
Verena Valley, MD: When to Seek Medical Care
eMedicine.com, Inc., Patient Education Article; 2005.

Mart Mannik
and Bruce C. Gilliland: Etology and Pathogenesis
Harrison's Principles of Internal Medicine; Eight Edition, vol. 2, ch. 364 DEGENERATIVE JOINT DISEASE, p. 2071.

Mart Mannik
and Bruce C. Gilliland: Clinical Manifestations
Harrison's Principles of Internal Medicine; Eight Edition, vol. 2, ch. 364 DEGENERATIVE JOINT DISEASE, p. 2072.

Mart Mannik
and Bruce C. Gilliland: Diagnosis
Harrison's Principles of Internal Medicine; Eight Edition, vol. 2, ch. 364 DEGENERATIVE JOINT DISEASE, p. 2073.

Mart Mannik
and Bruce C. Gilliland: Treatment
Harrison's Principles of Internal Medicine; Eight Edition, vol. 2, ch. 364 DEGENERATIVE JOINT DISEASE, p. 2073.

Library of Congress: What causes the noise when you crack a joint?
6/2004.

Best wishes,
The Prison Hospital

Prisoner: Look here, doctor! You've already removed my spleen, tonsils, adenoids, and one of my kidneys. I only came to see if you could get me out of this place!

Doctor: I am, bit by bit.