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Reminder: Get a Flu Shot

The flu is caused by the influenza virus, which circulates in the air when someone with the flu coughs, sneezes or talks. People nearby can breathe it in and get infected. The influenza virus can also be picked up by touching a surface (such as a doorknob) that was contaminated by someone with the flu. Any time you're around someone with the flu, you are at risk for getting it.

What Is Nerve Pain?

This will likely be one of the first questions your doctor asks if you complain of chronic pain. Unless there is an obvious reason for pain, your doctor needs a lot of information to identify the underlying cause. This includes the location, type, intensity and frequency of pain. The doctor is partly trying to determine whether the pain is nociceptive or neuropathic (also called nerve pain), or possibly both.

Ask The Doctors: October 2018

For a chronic pain condition, such as osteoarthritis, heat seems to work best. However, some people find that cold also helps to dull the pain. So the answer is, try them both and use whichever works best for you. Exercise is an important part of treatment for osteoarthritis. Heat and cold can also be used to make exercising a little easier. Try using heat before exercise to loosen up muscles and cold afterwards to minimize any achiness.

Bone Health and Fracture Risk

Bone density is measured with a dual-energy X-ray absorptiometry (DXA) test, which provides a T-score that shows how much lower your bone density is than a typical healthy 30-year old adult. The two areas usually tested are the hip and spine. A T-score between -1 and -2.5 means your bone density is low and is called osteopenia. If the T-score is -2.5 or below, it means you have the bone-thinning disease osteoporosis. Both conditions increase the risk for bone fractures

Ask The Doctors: September 2018

Hip arthritis is usually experienced as pain in the groin. It can also cause pain on the front of the thigh or even pain around the knee. Having achy joints can be frustrating. It may seem logical that resting the joint will help. But, in fact, the opposite is true. Joints are meant to move, and they need movement to be healthy. The mobile joints in the body are lined with a membrane that secretes synovial fluid, which provides nutrition and lubrication. Some form of compression (from walking or other physical activity) is needed to circulate the nourishing synovial fluid across the joint.

Download The Full September 2018 Issue PDF

Imaging studies have a limited role during the early stages of back pain, yet more than half of people with low back pain receive an imaging study. People with back pain often are inappropriately told to rest and stop work. Only half of people with low back pain are prescribed exercise, which is the most effective treatment.

Stem Cell Therapy: Hope for Arthritis or Just Hype?

Hundreds of stem cell clinics have popped up across the country, many of them hoping to cash in on the enthusiasm surrounding this treatment. The field, particularly in the past five years, has been overrun with a large number of people who have co-opted the word stem and have been using it as a marketing tool to offer therapies to patients that are as yet unproven, says Dr. Muschler. That practice is a misuse of the term stem cell and amounts to selling false hope.

In The News: August 2018

Low back pain is a common problem and a leading cause of disability. A variety of treatments are used to address it. Recent guidelines from the American College of Physicians recommend nondrug treatment first, including heat, massage, acupuncture and spinal manipulation by a chiropractor or other healthcare provider. Findings from a study published in JAMA Network Open (May 2018) back up the effectiveness of spinal manipulation. The study included 750 active-duty service members aged 18 to 50 with low back pain. Half of them received usual medical care, including medications, physical therapy and referral to a pain clinic. The other half also received up to 12 visits with a chiropractor for spinal manipulation and other therapies. After six weeks, the group receiving usual care plus chiropractic care had greater improvements in lowering pain intensity and disability than those getting usual care alone.

New Shingles Vaccine

According to the CDC, Shingrix may be used in people with weakened immune systems. At this point, no studies have examined Shingrix in patients with autoimmune disease, cautions Dr. Calabrese. Shingrix includes a compound called an adjuvant that helps the vaccine create a stronger immune response. The adjuvant revs up the immune system, so there is a concern for exacerbating autoimmune diseases, explains Dr. Calabrese. Rheumatologists are awaiting further data on Shingrix in this patient population.

Ask The Doctors: June 2018

Ive had polymyalgia rheumatica for 10 years. I take low doses of prednisone. When I stop it, the symptoms return. Is there anything new to treat this disease? I had an attack of severe pain and swelling in my ankle and knee. Fluid was drawn and tested for gout. But no crystals were found. I was diagnosed with pseudogout. What is pseudogout?

Anesthesia: Less Is More

When you have a joint replaced, your anesthesiologists job is to keep you comfortable and safe during your surgery and as pain-free as possible after the procedure. In the past, that often meant going under general anesthesia and getting strong narcotics to dull the pain. Not anymore. Today, when it comes to anesthesia, less is more.

How to Discard Medications

Look in your medicine cabinet. Are there bottles of pills in there you no longer take? If so, its time to get rid of them, especially if there are opioid pain medications or other controlled substances among them.