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March 2010 
Back Surgery: Not Always a Last ResortWhen is it appropriate to forego non-surgical treatment and spring for surgery for back pain? According to a study published in the June 2009 Journal of Bone and Joint Surgery, patients with spinal stenosis (narrowing of the spinal canal, causing nerve compression) and degenerative spondylolisthesis (a slipped disk, usually due to arthritis) who chose to have surgery had substantially greater pain relief compared with those who did not choose surgery. The patients who had surgery also had better function, less pain, and higher satisfaction two and four years later compared with those who chose not to have surgery. Shared Decisions: A Give-and-Take Approach to Addressing Arthritis Pain In the past few years, a new approach to doctor-patient interaction has emerged, in which both the patient and health-care professional share information and jointly decide on a course of treatment. The approach, called shared decision making, allows patients to take more responsibility for their care by becoming better informed about their illness and the available treatments. A study in the November 2009 issue of Arthritis Care & Research suggests that increasing patients’ responsibility for making medical decisions may make them less willing to accept risky treatment options. The authors found that when patients learned about the side effects of a new medication, they were not as willing to take the drug when given a choice than if a physician simply wrote a prescription for it. New Treatments May Halt OA Progression Nearly 27 million Americans suffer the debilitating effects of osteoarthritis (OA). Medical care for OA costs U.S. insurers and patients $185.5 billion a year, according to a study in the December 2009 issue of Arthritis & Rheumatism. These figures, along with a burgeoning aging population, point to the growing need for better OA therapies. "We do have treatments for the relief of OA symptoms, including pain and stiffness, and for the improvement of quality of life," says M. Elaine Husni, MD, Vice Chair, Arthritis and Musculoskeletal Treatment Center, and Director, Clinical Outcomes Research in the Orthopaedic and Rheumatologic Institute at Cleveland Clinic. "Unfortunately, we do not yet have approved medications that slow the disease or change the course of the disease." Range of Motion: 5 Ways to Ease Stiff Joints Range of motion refers to the normal amount your joints can move. Daily activities, such as housework or climbing stairs, won’t move your joints through their full range of motion. You’ll need exercises like the following to reduce stiffness and maintain joint flexibility. Advances in Elbow Replacement Elbow replacements don’t enjoy the popularity of their hip and knee counterparts, but they’re no less appreciated by the people who receive them. This relatively uncommon surgery can relieve pain and restore mobility to an elbow decimated by acute injury, rheumatoid arthritis, lupus, or other inflammatory conditions. "People come in and often can’t get their hand to their mouth, but after surgery they’re feeding themselves," says Peter Evans, MD, PhD, Director of Cleveland Clinic’s Upper Extremity Center. "The procedure really is life-changing." |
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