Take off those heels

Your article on high heels, “Ouch” [June 18], offers a perfect description of an awful and largely ignored habit.

Thirty years ago, working as a nurse and radiology department administrator, I saw droves of 35-to-45-year-old women filing through our halls because of lumbar spines irreversibly damaged by heels. It’s also been barely 30 years since heels in general, not just towering heels, were decried by the medical world. Thank you for a very instructive reminder about vanity’s cost to health.

Jan Dirckx, Winchester, Va.

Relieving muscle pain

Thanks for the article on trigger points, “These muscle knots cause pain that spreads” [June 18]. Doctors are very ignorant when it comes to muscles. Months after I had my second hip replacement, I had disabling pain in my knees. The orthopedist took X-rays which showed nothing wrong with my joints, so I asked for a referral to a very good physical therapist I’d been to before. He knew exactly where to massage my legs to get the knots to loosen. There is also a good book, The Trigger Point Therapy Workbook, that can help anyone to do self-massage. It takes some time, but it works! I’m still working on getting all my strength back, but I have very little pain now and can make it better myself.

Nancy S. Pyle, Staunton, Va.

Your article says that “medicine has only recently come to understand” myofascial pain. This is far from the case. Seventy years ago, Janet Travell was developing treatments for what was (in the 1940s) a new idea. Her treatments are documented in the two-volume textbook she co-authored with David Simons, “Myofascial Pain and Dysfunction: The Trigger Point Manual,” as well as in dozens of journal articles. Her detailed charts showing referred pain patterns and the location of trigger points that cause each pain pattern are available on the Internet, as are the textbooks. She describes dry needling, but she actually favored a stretch technique that can be practiced by many kinds of practitioners who are not licensed to insert needles. She presented papers and gave continuing education courses that reached thousands of practitioners.

As an acupuncturist, I treated these syndromes many times, using both Oriental theory and Dr. Travell’s techniques. Her treatments are incredibly effective yet apparently have been forgotten or, more likely, never learned by doctors who see pain-syndrome patients daily.

Jo Ellen Hayden, Owings

Amy Mathews Amos, the article’s author, replies:

Dr. Janet Travell was indeed a pioneer in describing and treating trigger points and referred pain decades ago. It’s not that medicine has forgotten this but rather that many in medicine never fully accepted it. According to practitioners and researchers I interviewed for this article, Travell and Simon’s work doesn’t satisfy medicine’s “gold standard” of rigorous, statistically tested clinical research with randomized, controlled trials. As a result, some in the medical community consider their work not sufficiently supported yet.

Living with diabetes

Regarding “A child with diabetes, a quarter-century later” [June 18]: My 14-year-old son was diagnosed with Type 1 diabetes last year. Beyond the obvious physical and emotional struggles, the confusion between Type 1 and Type 2 diabetes presents a big obstacle for him and others living with this disease. Confusion and misconceptions about these types have resulted in the perception that diabetes, as a whole, is no big deal. This attitude is adversely affecting awareness and fundraising efforts.

Jeanette Collier, a fellow mom of a Type 1 child, and I have filed a petition to revise the type classification names of both Type 1 and Type 2 diabetes to more accurately reflect the nature of each condition. It is already approaching 5,000 signatures.

Jamie Perez, Miami

Another approach to algae

Those streaks on your roof? They’re prehistoric.” [Urban Jungle, June 18] did not mention an effective way to remove roof algae without harming other vegetation: oxygen bleach.

Patricia Minami, Brookeville