What I Treat

Low Back, Sciatica, Buttock and Leg Pain

Common reasons people come in include:

• persistent or recurring low-back pain
• repeated low-back flare-ups
• SI-joint or SI-region pain
• buttock pain
• sciatica-type pain
• numbness or tingling into the leg
• pain aggravated by sitting
• pain aggravated by standing or walking

With leg symptoms, I am particularly interested in whether the problem appears to be coming primarily from the spine, the hip/pelvis, a peripheral nerve, or some combination.

“Radiating pain” does not automatically tell us where it is coming from.

How I Work

Neck, Shoulder and Arm Symptoms

I commonly work with:

• chronic or recurring neck pain
• pain between the shoulder blades
• shoulder pain with reaching or lifting
• anterior shoulder pain
• rotator-cuff or biceps-tendon-type shoulder pain
• arm pain
• numbness or tingling into the arm or hand
• thoracic-outlet-type arm symptoms
• symptoms involving both the neck and shoulder

Shoulder, neck and arm problems often overlap.

Sometimes changing how the shoulder blade, neck or arm is supported changes the familiar symptom immediately. Other times the painful area itself deserves more attention.

The goal is to find out which pieces actually matter.

Headaches

I often work with headaches when there appears to be a meaningful connection with:

• neck pain or stiffness
• jaw tension
• recurring sinus-type symptoms
• menstrual changes
• digestive symptoms
• persistent symptoms following an illness
• fatigue or other broader health changes

Not every headache belongs in a manual-therapy or herbal office. When the pattern suggests medical evaluation should come first, that takes priority.

Jaw Pain / TMJ / TMD

Common complaints include:

• chronic jaw tension or aching
• painful clicking or popping
• headaches associated with jaw tension
• pain around the temple or base of the skull
• restricted or uncomfortable jaw movement

I look at the jaw itself, but also at the neck and surrounding muscles.

Clicking by itself does not necessarily mean something needs treatment.

Significant locking, major loss of movement, dental problems, airway issues, or other joint concerns may require another provider as part of the picture.

Elbow and Forearm Pain

I frequently see people who have been told they have tennis elbow or golfer’s elbow, especially when the problem has persisted despite treating only the elbow.

Possible contributors can include the local tendon, forearm use, grip, the wrist and hand, nerves, or the neck and shoulder.

If changing something away from the elbow repeatedly changes the familiar elbow pain, that is worth paying attention to.

Carpal Tunnel, Hand and Wrist Symptoms

I work with hand and wrist problems more selectively, particularly when they occur alongside neck, shoulder or arm symptoms or have not responded well to local treatment.

That can include:

• carpal-tunnel-type symptoms
• hand numbness or tingling
• pain with gripping
• thumb pain
• weakness or loss of hand function

True carpal tunnel syndrome involves the median nerve at the wrist, but similar symptoms can sometimes have additional contributors elsewhere.

Progressive weakness, muscle loss or worsening neurological function deserves appropriate medical evaluation.

Mid-Back and Pain Between the Shoulder Blades

Pain between the shoulder blades can involve the shoulder blade, neck, thoracic spine, ribs, breathing mechanics or local tissues.

Because several areas overlap there, I usually start with the pieces that are easiest to change and retest.

Mid-back pain associated with chest symptoms, difficulty breathing, fever, significant trauma or other concerning symptoms should be medically evaluated rather than assumed to be musculoskeletal.

Hip and Pelvic Pain

Common presentations include:

• lateral hip pain
• “hip bursitis” or greater-trochanter-region pain
• buttock pain
• intermittent groin or anterior hip pain
• pain during walking or stairs
• hip pain that has persisted despite local treatment

One of the first questions is whether the hip is actually the main source.

Back problems can refer pain into the hip and buttock, while the way the hip and pelvis move can also affect the back.

Progressive loss of hip motion, strength or function may warrant medical or orthopedic evaluation.

Knee Pain

I commonly work with:

• pain around or behind the kneecap
• medial or lateral knee pain
• pain during stairs
• pain with squatting
• recurring activity-related knee pain

Knee symptoms are often useful to examine because we can reproduce them with a specific activity and then see whether changing how the leg is moving changes the pain.

If the problem behaves more like a significant joint injury or stops making sense as a movement-related problem, another evaluation may be more appropriate.

Heel Pain and Plantar Fasciitis-Type Symptoms

Heel pain is another area I see regularly.

That includes pain that has been called:

• plantar fasciitis
• tarsal tunnel
• nerve-related heel pain
• chronic calf/heel tightness or irritation

Sometimes the painful tissue at the heel appears to be the main issue.

In other cases, testing suggests that a nerve or the way the leg is moving is contributing.

Severe unexplained heel pain, significant trauma or concern for a stress injury should be medically evaluated.

Digestive Problems

I commonly work with:

• bloating
• nausea
• frequent belching
• reflux or heartburn
• IBS-type symptoms
• alternating constipation and diarrhea
• abdominal cramping

I am especially interested in the pattern over time—what tends to move together, what changes first, and whether the digestive system is becoming more stable.

Fatigue and Brain Fog

Herbal care may be useful when fatigue occurs alongside things such as:

• digestive symptoms
• post-meal fatigue
• brain fog
• cold intolerance
• disturbed sleep
• body aches
• post-viral symptoms

Sudden or unexplained fatigue, especially with major changes in breathing, heart rate, strength, weight or neurological function, needs appropriate medical evaluation.

Sleep Problems

I most commonly work with:

• repeated waking
• restless or unsettled sleep
• vivid dreams
• sleep disturbance occurring alongside other health changes

Trouble sleeping can have many causes, including medical sleep disorders, so herbs are not automatically the right answer simply because someone is tired.

Persistent Post-Viral Symptoms and Long COVID

I have substantial experience with people whose health changed after a viral illness and never fully returned to baseline.

Common combinations include:

• fatigue
• brain fog
• digestive changes
• headaches
• body aches
• altered temperature tolerance
• disturbed sleep
• anxiety or internal agitation
• reduced tolerance for normal activity

I use herbal treatment to work with the person’s current symptoms and function. I do not claim to eradicate a persistent virus or cure Long COVID.

When post-exertional malaise is present—where exertion produces a delayed and disproportionate crash in function—I am particularly cautious about simply pushing activity upward.

Headaches and Sinus-Type Symptoms

Herbal care may also be useful for:

• recurrent headaches
• sinus-type headaches
• chronic sinus congestion
• recurring “sinus” symptoms
• seasonal allergy symptoms

Because many different problems can feel like a sinus headache, I do not assume the label tells us the cause.

Menstrual and Hormonal-Pattern Symptoms

I sometimes work with:

• headaches around the menstrual cycle
• digestive changes associated with the cycle
• painful periods
• hot flashes
• night sweats

I do not frame this as generic “hormone balancing.” The treatment is based on the overall symptom pattern rather than the idea that every hormonal complaint has the same cause.

Widespread Pain and Multiple-System Symptoms

Sometimes the main complaint is not one painful body part.

Someone may be dealing with body aches alongside fatigue, sleep problems, digestive changes, temperature sensitivity, headaches or post-viral symptoms.

Those cases may be more appropriate for the herbal/internal side of the practice than for treating each painful area individually.

Chinese Medicine & Herbal Therapy

When another route may make more sense

Some problems are appropriate for me to help with directly.

Some are appropriate only alongside another clinician.

And some should be evaluated elsewhere first.

Examples include new or progressive neurological loss, concerning structural injuries, unexplained abnormal laboratory findings, acute or potentially serious medical problems, or situations where the risk of herbal treatment is higher than I am comfortable taking on.

I also intentionally do not use Chinese herbs to manage cancer or heart disease.

If I cannot build a reasonable case for why treatment here makes sense, I would rather help you identify the next useful direction than keep treating simply because you already started.