In the News: June 2017
About One-Quarter of Adults in America Have Arthritis
The prevalence of arthritis among adults in the United States is growing, according to new data published by the Centers for Disease Control and Prevention (CDC) in the monthly report Vital Signs (March 2017). Using data from the 2013 to 2015 National Health Interview Study, the CDC estimated that 54.4 million adults (about one in four) have doctor-diagnosed arthritis, including osteoarthritis (the most common type of arthritis) and others, such as rheumatoid arthritis, gout and fibromyalgia. About 24 million people with arthritis are limited in their activities, a 20 percent increase since 2002. The CDC also found that almost half of adults with heart disease or diabetes have arthritis, as do 30 percent of adults who are obese. The CDC advocates nondrug methods to manage arthritis. For example, physical activity can decrease pain and improve function by about 40 percent.
Exercise May Have Anti-Inflammatory Effects
Regular physical activity has many benefits for people with arthritis. For example, strengthening muscles around a joint can provide added support, which eases pain. New research suggests there may be one more reason to exercise. A study published in the journal Brain, Behavior and Immunity (March 2017) found that moderate exercise may have anti-inflammatory effects. Low-grade inflammation is thought to contribute to the symptoms of osteoarthritis. The researchers investigated the effects of moderate exercise in 47 study participants. Before and after the participants walked for 20 minutes on a treadmill, they submitted blood samples that were analyzed for the presence of substances that impact inflammation. The reserachers found that one exercise session resulted in a 5 percent decrease in the number of immune cells that produce the substance tumor necrosis factor (TNF), which plays a key role in inflammation.
Pregabalin Not Effective for Sciatica
The drug pregabalin (LyricaŽ) has been shown to be effective for fibromyalgia and for some types of nerve pain. But when it was put to the test for sciatica it fell short. Sciatica occurs when the sciatic nerve, which originates in the lower spine, is compressed, causing pain that can radiate down the leg. In a study published in the New England Journal of Medicine (March 2017), 209 people with sciatica were randomly assigned to take pregabalin at a dose of 150 mg per day (which could be increased to a maximum of 600 mg per day) or placebo. After eight weeks there was no difference between the groups on the primary outcome of intensity of leg pain, nor was there any difference in the extent of disability, intensity of back pain or quality of life.
Weight-Loss Surgery Can Improve Outcomes of Joint Replacement
People who are morbidly obese (body mass index of 40 or more) are more likely than people of normal weight to have complications from joint replacement surgery. Weight-loss surgery (called bariatric surgery) can lead to drastic weight loss, but it hasn’t been known whether it is helpful for people undergoing joint replacement. In a study presented at the Annual Meeting of the American Academy of Orthopaedic Surgeons (March 2017), researchers analyzed data on over 2,600 morbidly obese patients undergoing total knee replacement and 792 having total hip replacement after bariatric surgery. Knee replacement patients were 75 percent less likely to have in-hospital complications than a control group that had not undergone bariatric surgery before joint replacement. Bariatric surgery reduced these complications by 31 percent for hip replacement patients. Bariatric surgery also reduced complications within 90 days of either type of surgery. It did not reduce the risk for needing a revision surgery.