The Cleveland Clinic Arthritis Advisor

Volume 7
Number 7
July 2008

Many of the charts & tables found on this site are PDFs.

July 2008

Advances in Achilles Tendon Surgery Speed Procedure and Recovery
The Greek warrior Achilles, according to mythology, was felled by a poison arrow shot into the one place he was vulnerable—his heel. Fast-forward 2,700 years to today, when cutting-edge medical care can not only repair an injured Achilles tendon but can have you walking without casts or aids in mere months. "New radio-frequency treatments and other minimally invasive procedures are now among the methods we can use with patients who injure or rupture their Achilles tendon," says Brian G. Donley, MD, director of the Foot and Ankle Center at Cleveland Clinic’s Department of Orthopaedic Surgery. As with any medical procedure, the latest surgical advances won’t work for all patients with Achilles tendon problems. Some procedures are targeted for tendonitis, an inflammation of the tendon. Others treat tendonosis, in which scar tissue develops on the tendon or the tendon weakens and develops microscopic tears. And some procedures focus on treating a tendon rupture, in which the tendon actually tears.

Physical Therapy: Rx for Building‘Happy’ Joints
If you’ve been diagnosed with osteoarthritis (OA), rheumatoid arthritis (RA), or another type of arthritic disease, your physician will no doubt establish a treatment plan centering on a rigorous schedule of medicinal therapy. In addition, your physician is apt to recommend, if not prescribe, an appointment with a physical therapist. "The role of medication is to reduce the inflammation in your joints, and it can usually accomplish that, at least partially," explains Jeanne Markusic, MS, PT, a clinical specialist in physical therapy at Cleveland Clinic’s Spine Center, "The physical therapist’s goal, on the other hand, is to increase the patient’s strength and flexibility and to minimize abnormal stress on the affected body part."

Are You at Risk for Opioid Addiction?
Opium-based pain medications such as oxycodone (OxyContin), meperidine (Demerol), propoxyphene/acetaminophen (Darvocet), and hydromorphone (Dilaudid) present a perplexing risk vs. benefit problem, both for the patient and the doctor. Opioids are the most effective drugs for treating pain, but they have the potential to cause both psychological and physical dependence. Many patients "underdose" themselves because they are afraid of addiction, and many doctors are reluctant to prescribe these drugs because of legal risks. Even those in the medical community are split, some saying the risk of addiction is great, others—primarily those who specialize in pain management—believing the risk in older adults is overstated. "Older individuals tend to have a lower risk for addiction with first- time exposure to dependence-producing agents," says Teresa Dews, MD, a pain-management specialist at Cleveland Clinic. "There also is a known segment of people who have an addiction as a pre-existing medical condition, estimated to be between seven and 12 percent of the U.S. population. If some of these individuals are exposed to opioid or narcotic medications for treatment of pain syndromes, a pre-existing addiction may be activated or reactivated."

Try Massage for OA Pain Relief
More than 100 years ago, Dr. John Harvey Kellogg, the creator of Corn Flakes breakfast cereal, studied the benefits of massage and found that it increases circulation and aids the nervous system. This was just the beginning of the long line of benefits that massage can provide. A century later, there’s an increasing body of research to show that massage can help alleviate symptoms that result from a number of medical conditions, including osteoarthritis (OA). "There is definitely an acceptance now," says Karen Ellen Fink, LMT, RN, BSN, CLL, massage therapy coordinator at Cleveland Clinic’s Center for Integrative Medicine. "More doctors are referring OA patients for massage because it simply makes them feel better. Many patients are now taking less medication and they require fewer doctor visits."