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Dr. Internet will see you now

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As my body continues to fall apart, gradually, I’ve been using the Internet to diagnose my various woes. A trivial example: I woke up a few weeks ago with a condition that I learned from eyehealthweb.com is called “puffy eyes.” I queried my son in medical school, and he texted me back one word: “Benadryl.” That was easy.

More ominously, I developed sciatic pain last month down my right leg. That was followed by pain in what may or may not be the upper reaches of the gluteal muscles; there weren’t any anatomy classes required for my comparative literature major, alas. Aggregating information from websites such as webmd.com and spine-health.com, I figured out that this was probably an impingement of the piriformis muscle, a tiny little sinew that hangs off the side of your hip.

I followed the websites’ advice, implementing some new stretches, icing the area, and trying to rest. There has been some improvement, knock on wood.

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I can’t imagine that diagnosing yourself on the Internet is a good idea. But I bet millions of people do it every day. It’s not that easy to get in to see a doctor. My wife and I joke that when you finally do show up at the doctor’s office, you’re told that your flu/bronchitis/pneumonia-like affliction is “viral,” and that you should go home and get some rest.

So what does a professional say?

Dr. Deeb Salem, chairman of the department of medicine at Tufts Medical Center, says he’s been monitoring medical websites for well over a decade. “I think the Internet has helped patients, and even physicians, avoid a lot of bad paths,” he says. “The danger is that the lay public has trouble filtering. If I go on the Internet, I know what’s crazy and what’s not.”

He offered an example: parents who want to treat a child’s acne. A Google search for “acne treatment” produces three sponsored results at the top of the page, led by an ad for Proactiv, an over-the-counter treatment kit. “Of course pharmaceutical companies are trying to reach patients through the Internet,” Salem says, “and there is almost no policing of that.”

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The top five “natural” Google hits link to four sites we might consider reliable: webmd.com, medicinenet.com, the Mayo Clinic, and the American Academy of Dermatology. The Proactiv web page also pops up in the top five results, which probably means that the company has invested heavily in search engine optimization, i.e., jacking up their Google ranking.

While we’re on the subject, don’t doctors themselves cull a great deal of information online?

They do, from a product called UptoDate, a continually updated database of medical research and treatment options. I’m told the website, headquartered in Waltham, is ubiquitous in modern medicine, a sort of Bloomberg terminal for doctors.

So what about acne treatment? You’re better off consulting UptoDate, which means getting a printout from your doctor, because it’s subscription-based and accepts no ads. Thus, no miracle cream or lotion can buy its way into your search, as it can with Google or Yahoo.

How about my hip problem? Trickier, even with UptoDate’s sophisticated database. It regards piriformis as a subset of lower back pain, and doesn’t mention physical therapy among the top five recommended “nonsurgical interventional treatments.”

“We cover rheumatology and sports medicine in depth, but we don’t cover orthopedic and some soft tissue concerns as well as we’d like,” the website’s general manger, Dr. Denise Basow, told me. “We never intended to be full service for consumers.”

I’m seeing a hip doctor later this week. Something tells me that’s the relief I’m seeking.

Alex Beam’s column appears regularly in the Globe. He can be reached at alexbeam@hotmail.com.

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