Rheumatic patches - a common cause of inexplicable pains
Dr David Freed is the expert on rheumatic patches and this page explains his work.
A rheumatic patch is a sensitive patch of skin which hurts when gently pinched. They are most often found over the scalp, neck and back but can be present anywhere in the skin. There is a real pathology there too – haphazard collagen bundles, fewer hair and sweat glands with infiltration by white cells. Look for them yourself by gently picking up an “as shallow as possible” fold of skin and squeezing it between your fingers. Occasionally there are tiny thread veins of skin tags associated with rheumatic patches. People don’t know they have them until they look for them. Osteopaths, chiropractors, acupuncturists, etc. all know about them and treat rheumatic patches, but probably call them something else!
What is so important about rheumatic patches is that they are often misdiagnosed as something else – prolapsed disc, cervical spondylosis, sciatica, sacroiliac strain, fibrositis, fibromyalgia, neuralgia, stiff neck, whiplash injury, repetitive strain injury, even plantar faciitis. Even migraine can be associated with rheumatic patches in the scalp.
Dr Freed suspects the rheumatic patch is the earliest lesion of arthritis. Most patients with established arthritis have pain for years before they have serious joint problems or x-ray changes. If rheumatic patches are treated at an early stage, progression of arthritis can be halted.
The rheumatic patch is an area of “stiffness” in the skin. One feature of stiffness which the structural engineers tell us about is that lines of force tend to be concentrated through stiff patches, which makes them vulnerable to mechanical stress. Thus any structural imbalance in the body for whatever reason, (lopsidedness, poor posture, muscle strain etc) concentrates stress lines through the stiff patches and causes pain. A Dowager’s hump is a typical large rheumatic patch.
The main symptom is pain but one may also experience itch, twitch, “ants crawling”, parasthesia or even restless leg symptoms.
The trigger points of fibromyalgia are also rheumatic patches. Indeed, to diagnose fibromyalgia there are 18 trigger spots that are looked for, mainly on the upper body, i.e. neck, shoulders, and chest, because this is where the lines of force are and the tissue and skin of the body “hangs” off the skeleton.
Treatment of rheumatic patches
This is tackled by:
- Preventing the stiff area of the skin from being there at all.
One cause of stiff areas is food intolerance, possibly intolerance of lectins. Such an intolerance may be triggered off by an acute viral infection. Indeed, the old advice of “starving a fever” may have been useful in preventing rheumatic patches from developing. Lectins are natural plant toxins and the main source is wheat. However, some patients have specific food allergies. Magnesium deficiency is another possible cause, as is essential fatty acid imbalance.
- Doing the Stone Age diet – this alone may cure the problem.. More often I now prescribe the ketogenic diet - please see Ketogenic diet - the practical details and My book The PK Cookbook - Go Paleo-ketogenic and get the best of both worlds
- Improving posture, muscle tone and balance (rheumatic patches are very rare in athletes and gymnasts) – see a good physiotherapist or osteopath.
- Dr Freed treats rheumatic patches by injecting the skin with a dilute solution of salicylic acid. Whilst this is undoubtedly effective, it really is a first aid measure and the effects are not long lasting.
Dr D Freed (allergist), 14 Marston Road, Salford, Manchester M7 4ER; Tel: 01617956225
Another possible treatment – mineral creams
I always like to think “causation” and “mechanisms”. Rheumatic patches are all about the connective tissue or fascia that links skin to muscles and then runs into tendons and bones. The raw material that makes this is the same but what differs is the level of stiffness or stickiness of that tissue. I am amazed by how extraordinary skin is – elastic, tough and pliable. How does connective tissue stick with just the right degree of stickiness? Connective tissue is electrically alive – physically it is a colloidal gel and fascia is the fuzz that holds things together. I do not know but my guess is that this stickiness is electrochemical rather than physical. It may be that what we perceive to be muscle stiffness is in fact connective tissue stiffness. The muscle stiffness is reflex to protect us from tearing the connective tissue when it is too sticky. See Muscle stiffness
This may explain why Epsom salt spas and baths have stood the test of time with a long history of improving arthritic lesions. Anyone with arthritis could benefit from a daily bath with 500grams (one pound) of Epsom salts dissolved and a 15 minute soak. Minerals are all positively charged and magnesium, in particular, is commonly deficient. See Magnesium - treating a deficiency
If this is not possible or convenient then try the magnesium or mineral creams. Early clinical feedback has been most encouraging – often the symptom of stiffness resolves quickly! See Minerals and vitamins delivered through the skin.
- Stone Age diet
- Ketogenic diet - the practical details
- My book The PK Cookbook - Go Paleo-ketogenic and get the best of both worlds
- Muscle stiffness
- Fox WW (1981) Arthritis: Is your suffering really necessary? Robert Hale, London
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