Monmouth County's Ask the Doctor

Q: What are COVID Toes?

A: As the world continues to struggle with the COVID-19 pandemic, new symptoms of the virus continue to be identified. One such symptom, purple or red lesions on the toes and hands, has been dubbed “COVID toes” and has gained attention over recent weeks. Rashes have been associated with the coronavirus more than other viral infections but not a sure and definite sign someone may have COVID.

Dr. Sanjay Gandhi, DPM

These rashes on toes are newer symptoms and have been emerging and show how people can react to infections in different ways. Some of these symptoms actually aren’t new in the realm of viral infections. It’s not uncommon for someone to have a viral infection and have a rash or blotchy area on their body. COVID toes are just another way that the body can respond to a viral infection. Should you notice a rash or COVID toes in addition to the common symptoms of the coronavirus, it’s best to contact your healthcare provider sooner than later.

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The use of Electroacupuncture for the Treatment of Discogenic Sciatica By: Hitomi Asano Sciatica refers to the pain that radiates along the path of the sciatica nerve, which branches from the lumbar spine of the lower back through the hips, buttocks, and down the leg. Nearly 90% of sciatica cases are discogenic in origin and most likely caused by a lumbar disc herniation. It may be accom- panied by neurologic deficits, such as leg pain, leg paraesthesia (numbness and tingling), and low back pain. Current treatments for discogenic sciatica include surgical and conservative treatments. Surgical procedures can range from spinal fusions to discectomy. Conservative treatments can range from medication, PT, spinal injections, etc. Electroacupuncture (EA) has been used to treat sciatica for many decades in China. Studies have reported that EA may effectively alleviate neuropathic pain and relieve sciatica symptoms. A randomized clinical trial in 2017 compared the effectiveness of electroacupuncture vs medium-frequency electro- therapy (MFE) for discogenic sciatica. MFE is also known as interferential current (IFC), a modality used by physical therapists and is similar to transcu- taneous electrical nerve stimulation (TENS). In the study, they recruited 100 participants and randomized into 2 groups: EA and MFE. The EA group received acupuncture and electrical-stimulation at BL25 dachangshu on the affected side and bilateral Huato Jia Ji points corresponding to the lumbar disc herniation using 50 Hz frequency and a com- fortably tolerated maximum current intensity. The acupoints and frequencies used in the MFE group were the same as those used in the EA group. The treatments in both groups were performed once daily for 5 sessions/week for the first 2 weeks and followed by 3 sessions/week for the following 2 weeks, with each session lasting 20 minutes. The decrease in leg pain score from baseline to week 4 differed significantly between the EA group and the MFE group. The mean change from baseline to the 4th week in average leg pain intensity was 2.3 in the EA group and 1.06 in the MFE group. While both modalities significantly reduced leg pain scores,

the EA group showed a more significant decrease compared to the MFE group. Furthermore, they found that the pain-relieving effect of the EA (but not MFE) lasted for at least 28 weeks. The long-term effects of EA were superior to those of MFE because the effects of EA persisted after the discontinuation of the treatment. In addition, the EA group experienced addtional benefits: low back pain and Oswestry Disability Index both improved significantly. This randomized controlled clinical trial demonstrated that the short-term and long-term effectiveness of EA were superior to those of MFE in improving the symptoms of leg pain and disability of chronic discogenic sciatica.

HITOMI ASANO Morganville Acupuncturist hitomi@advancedpmr.com 732-894-9200

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ASK THE DOCTOR

SUMMER 2020