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Cleveland Clinic, along with other healthcare institutions, has put new practices and policies into place to deal with the opioid epidemic. We spoke with Lisa Yerian, MD, Medical Director of Continuous Improvement at Cleveland Clinic, and Cleveland Clinic psychiatrist Mohsen Vazirian, MD, about the problem and the response. In this and future issues of Arthritis Advisor we will continue the discussion.

Do you sometimes have a painful neck? If so, you are in good company. About half of us will experience neck pain some time during our lifetimes. The good news is most neck pain is mild and will go away on its own or with simple treatment. It may be caused by a strained muscle or ligament, poor posture or repetitive stress.

When you think of joint replacement surgery, youre probably thinking knees or hips. But other joints can be replaced as well, including ankles. Fewer ankle replacement surgeries are done, partly because the technology has lagged behind that for hips and knees. This is changing.

Your incredible intricate hands allow you to do amazing things, from mundane jobs, such as opening jars or typing, to more refined tasks, such as woodworking or playing the piano. You may take your hands for granted, until something goes wrong. Hand pain, stiffness and deformities can occur for a variety of reasons and can complicate your life.

Its important to understand that while back pain is a common complaint, most people do not need surgery. Back problems can stem from a variety of causes, including muscle strains, herniated disks, osteoarthritis, spinal stenosis and others. Nonsurgical measures, such as physical therapy, core strengthening, nonsteroidal anti-inflammatory drugs and activity modification, usually relieve symptoms.

The temporomandibular joints (one on each side of your head) articulate the lower jaw to the temporal bone of the skull. These hinge-like joints, along with the jaw (masticatory) muscles, allow you to open and close your mouth and move your lower jaw from side to side. Thus you can talk, chew and yawn with ease.

A new study backs up earlier research suggesting that regularly eating fish may help reduce joint pain and swelling for people with rheumatoid arthritis. Fish contains omega-3 fatty acids, which are thought to have anti-inflammatory properties. For the study, published in Arthritis Care & Research (June 2017), researchers studied 176 people with rheumatoid arthritis who filled out questionnaires about their diet, including frequency of eating fish.

There is no cure for osteoarthritis, which can worsen over time. Treatment is aimed at relieving symptoms. The most effective treatment is weight loss if you are above ideal weight, says Dr. Day. Physical therapy, exercise and knee braces can help. Other options are nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen (Tylenol), supplements, and injections of corticosteroids or hyaluronic acid.

While it might seem that restricting calories would make you very hungry, Kirkpatrick says that its the opposite. Hunger actually goes down. Your body adjusts and you are satisfied with smaller amounts of food. You see the chocolate chip cookie, but you dont have to have it. A patient of Kirkpatricks who just started a fasting plan noticed that she felt some hunger in the evening. She expected to be starving the next morning, but she actually had little appetite when she woke up.

When your back or neck aches, you may reach for pain relieving medications. While they can help, experts suggest trying nondrug treatments first. For both short-term and longstanding low back pain, for example, the recently updated guidelines by the American College of Physicians recommend starting with therapies such as heat, massage, exercise and spinal manipulation.

lasting less than 12 weeks the ACP recommends nondrug treatments, such as application of heat, massage, acupuncture or, possibly, spinal manipulation by a chiropractor or osteopathic physician. If this is not successful, you can add medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Advil, Motrin) and naproxen (Aleve), or muscle relaxants, including cyclobenzaprine (Flexeril).

Youve probably seen the ads on television-a celebrity with osteoporosis talking about a drug thats protecting her bones. If you need an osteoporosis drug, should you take the one the celebrity ispromoting?There are several osteoporosis drugs on the market. They may be taken as a pill, a shot or an infusion. Chad Deal, MD, Head of the Center for Osteoporosis and Metabolic Bone Disease at Cleveland Clinic, and associate editor of Arthritis Advisor, helps us sort out the variousoptions.