August 2016

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Subscribers Only — If the pain doesn’t reflect the anatomical problem, how can your doctor know what’s behind it? “It starts with a good history and a physical examination,” Dr. Murray says. Certain clues can point a diagnosis away from the knees and toward the hips. “If the knee has good range of motion and no tenderness but the hip has poor range of motion, then you’re tipped off that maybe this is somebody who has a hip problem and not a knee problem,” says Dr. Murray. An X-ray should confirm the diagnosis by revealing joint erosion and cartilage loss in the hip and intact joints in the knees.   More...

Calcium and Vitamin D; Balancing Exercises

Calcium and vitamin D are both essential for bone health. Current guidelines recommend that women age 51 and older and men age 71 and older need 1,200 mg of calcium a day, and men age 51 to 70 need 1,000 mg a day. Your body cannot make calcium. Ideally you should get calcium from the food you eat. Dairy products are the richest source. You’ll get about 415 mg of calcium in 8 ounces of plain, low-fat yogurt, about 293 mg in 8 ounces of reduced-fat milk (2% milk fat) and about 307 mg in 1.5 ounces of cheddar cheese.   More...

Biosimilar Drug Approved for Rheumatoid Arthritis

Drug manufacturers have recently devised methods to make approximate copies of some biologic drugs that, while not exact, are similar enough to the original to have the same therapeutic effect. The FDA decided to accept these “biosimilars” as long as the drugs meet strict standards of efficacy and safety. So far, two have been approved in the United States—Zarxio (a biosimilar of filgrastim) for cancer and Inflectra (a biosimilar of infliximab). In Europe, there are 22 biosimilar drugs.   More...

Chinese Herbal Medicine

Subscribers Only — Some people with painful arthritis look to Eastern medicine for added relief. Chinese herbs, for example, offer the promise of a natural remedy for symptoms. They are natural and can be effective. They are also serious medicine and should be treated as such. Even though you can go online or to a store to buy Chinese herbs, including formulas touted for helping arthritis, you shouldn’t.   More...

Zap Away Back Pain

Subscribers Only — Back pain is very common, and the RFA procedure is not for everyone. “Candidates for RFA are people with low back pain from osteoarthritis in facet joints who are not adequately helped with other methods,” says pain specialist Russell DeMicco, DO, in the Cleveland Clinic Center for Spine Health. Facet joints are pairs of small joints behind each vertebra. They join each vertebral body to the one above and below and are synovial joints, like the ones in your hands.   More...

Pinpointing the Source of Pain

Subscribers Only — Called “referred pain,” this shift in sensation happens because of shared nerve pathways. Nerve signals from different parts of the body travel along the same pathways. Sometimes the brain misinterprets the signals coming from one part of the body as originating from another part—for example, mistaking hip pain for knee pain. Referred pain isn’t the same as radiating pain, which is simply an extension of the original pain down a nerve (for example, shoulder or neck pain can radiate down a nerve to the arm).   More...

Hip Replacements, Tai Chi, Metabolism Changes, and Gout

Two surgical techniques can be used for total hip replacement, and there is debate about which is superior. Tai chi, a low-impact, slow-motion exercise that combines gentle movements with meditation and deep breathing, has been found in some small studies to help people with arthritis. Studies have shown that people who lose weight often have difficulty maintaining the weight loss and may eventually regain most or all of the pounds lost. An analysis published in a journal found that newspapers often print misleading articles about gout.   More...

Deformities of the Big Toe

High-heeled shoes often are blamed for causing bunions. But heredity is a more likely cause. For about 65 percent of people with bunions, they run in the family and can even develop at a young age. About 7 percent of people ages 12 to 14 have a bunion. Biomechanical problems, such as having flat feet, tight muscles, or reduced range of motion in the ankle, can also lead to bunions. High heels are not completely off the hook. Bunions can be made worse by ill-fitting or high-heeled shoes.   More...