Pain Management

Your spine is a column made of a stack of small bones (vertebrae) with the spinal cord running through it. Each vertebra has a cylindrical part (inside is the spinal cord and nerve roots), on the back of which is a bony ring with spiky projections (called the spinous process). The cylinders are stacked on top of one another and separated with shock-absorbing cushions (disks).

Good posture can go a long way toward relieving chronic musculoskeletal pain, especially in the neck, back, hips and knees. But, its not likely that any of us has picture perfect posture, says Cleveland Clinic physical therapist Mary Morrison, PT, DScPT. Over the years, we tend to become less flexible in our muscles, connective tissue and joints, and our bodies start to adapt to how we typically align ourselves in our daily activities.

When you think about hip pain, osteoarthritis in older adults may be what comes to mind. Osteoarthritis is a common cause of hip pain. But the hip joint is susceptible to many other conditions as well, and they can affect people of all ages.

Having osteoarthritis has been linked to an increased risk for heart disease. But the reasons for the connection are not known. Results of a study published in Arthritis & Rheumatology (August 2019) suggest that use of non-steroidal anti-inflammatory drugs (NSAIDs) may be, at least partly, to blame. Researchers analyzed data from Canadian health databases on 7,743 people with osteoarthritis and compared them to 23,229 people of similar age without osteoarthritis. Those with osteoarthritis had a 42% higher risk for heart failure, a 17% higher risk for coronary heart disease, and a 14% higher risk for stroke. The researchers reported that about 41% of the total effect on increased heart disease risk was attributable to current use of NSAIDs. This was an observational study, and the authors acknowledge that prospective studies (which compare people randomly assigned to different groups) are needed to confirm the findings.

A: The short answer to your question is no. But that doesn't mean there's nothing you can do about it. Osteoarthritis is caused by the degeneration of cartilage, and it cannot be reversed. Where two bones meet to form a joint the ends of the bones are covered with cartilage, which is a tough slippery material that allows the bones to glide smoothly over each other. At the most mobile joints (called synovial joints), which are the hips, knees, shoulders, elbows, wrists, fingers, ankles and toes, the cushioning cartilage can wear down. The reasons are not known, but it is partly a function of aging. Close to 50% of Americans ages 65 and over have arthritis.

Aromatase inhibitors are used mainly in two situations. First, a woman newly diagnosed with a breast cancer tumor of a specific size who has undergone surgery will be given an aromatase inhibitor to take for five years, and possibly up to 10 years, to prevent the cancer from coming back. "This is someone who doesn't have cancer right now," says Dr. LeGrand. "It's given for prevention."

Uric acid is a waste product of natural processes in the body. It is eliminated through the gastrointestinal tract and kidneys. If not enough uric acid is removed, it can accumulate in the blood. Once levels exceed 6.8 milligrams per deciliter (mg/dL), uric acid can leave the bloodstream and settle in joints, tendons and under the skin.

To strengthen the calf muscles and small muscles of the ankles and feet, try this simple exercise: Stand up tall and rise straight up on your toes. Try to stay stable for three seconds. Have your hands hovering over a surface (close but not touching) for safety. Work up to doing this 20 times. Eventually, try doing this on one foot. Start with five repetitions.

A short course of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve), can be used as long as there are no reasons not to take them. NSAIDs should be used cautiously in certain people, including those with a history of stomach ulcers, kidney disease, heart disease or stroke. Talk to your doctor to ensure you are taking the drugs safely. Your doctor also may prescribe a stronger NSAID.

Anyone can get the flu. It usually lasts about a week and often requires bed rest for a few days. Some people are at high risk for developing flu-related complications, such as pneumonia. They include children, older adults and people with some chronic diseases (including rheumatoid arthritis and psoriatic arthritis). During the 2017-2018 flu season, close to 1 million people were hospitalized for the flu, and there were 79,400 deaths from the flu.

NSAIDs are effective because they block an enzyme called cyclooxygenase (COX), which exists in two forms-COX-1 and COX-2. These enzymes make chemicals called prostaglandins, which contribute to inflammation in the body.

COX-2 inhibitors were developed to avoid the stomach problems that can occur with traditional NSAIDs. The COX-1 enzyme protects the stomach lining from corrosive effects of stomach acid, so it was thought that inhibiting just COX-2 would be easier on the stomach. But COX-2 also has a protective effect. The risk for stomach issues is about 50% lower with COX-2 inhibitors than with nonselectiveNSAIDs.