Pain Management

Adults Need Vaccines Too

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.
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Download The Full October 2019 Issue PDF

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.
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Use NSAIDs Cautiously

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.
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In The News: October 2019

People with osteoarthritis in the knee or hip may be at increased risk for heart disease, according to a study published in the journal Osteoarthritis and Cartilage (June 2019). The researchers studied 469,177 residents of southern Sweden who were 45 to 84 years old in 2003. They analyzed health data from 2004 to 2014. Overall, 15,901 of the residents had osteoarthritis in the knee, hip, hand or other joints. For most causes of death, the researchers found no difference in risk between people with osteoarthritis and those without it. However, people with osteoarthritis in the hip or knee were almost 20% more likely than the general population to die of heart disease. Most deaths were from ischemic heart disease (from clogged arteries) and heart failure. The risk increased with duration of osteoarthritis. The increase is thought to be due to mobility problems and lack of physical activity among people suffering with painful joints. The study highlights the need to find pain-free ways to stay active.
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Don’t Ignore Ball-of-Foot Pain

The plantar plate is a fibrous structure underneath the foot that supports and stabilizes the joints between the toe bones and the bones of the foot. (These are the metatarsophalangeal joints [MPJ].) The plantar plate, which is made of collagen, consists of bands that provide attachments for ligaments that go to each toe and that go between toes. These keep toes straight (preventing them from drifting up) and also in alignment (preventing the toes from separating).
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Should You Get a Partial Knee Replacement?

Osteoarthritis results from the deterioration of cartilage in joints. Cartilage is the tough material that covers the ends of bones, providing a smooth gliding surface. In the knee joint, where the thigh bone (femur) meets the shinbone (tibia), there are three places where bones make contact. One of them is on the inside (nearest the opposite knee, referred to as medial) and one is on the outside (farthest from the opposite knee, referred to as lateral). The kneecap (patella) is the third point of contact.
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Get Nutrients from Food

For optimal bone health, we need a combination of multiple nutrients, including calcium, vitamin D, vitamin K and magnesium. Recommended calcium intake is 1,000 mg a day for men up to age 70 and women up to age 50, and 1,200 mg a day for women over age 50 and men over age 70. "If you can't get that much from food, try to get at least half," says Ilic.
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Children Get Arthritis Too

Juvenile arthritis can present in much the same way as adult-onset arthritis, with joint swelling, stiffness and soreness that's more pronounced in the morning or when children are active. In an active child, these symptoms can be hard to tease apart from the normal aches and pains of playing sports, which is why a thorough diagnosis with a complete health history is important. That's often followed by imaging scans, such as ultrasound or MRI, to give the doctor a closer look at the child's joints.
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Ask The Doctors: October 2019

Corticosteroids are powerful anti-inflammatory medications. They suppress inflammation and pain, and they also suppress the immune system. If the immune system is weakened in any way, it can put you at increased risk for infections. A possible complication of any joint replacement surgery is infection. While this occurs only rarely, the risk is increased if the immune system is impaired. For this reason, people should wait to have joint replacement surgery after having a steroid injection until the immune system has had time to recover.
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Golf is an appealing sport for millions of Americans, including about 17 million people over age 50. Getting older doesnt diminish the desire to play, but it can present some new challenges.
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Get Ready for Golf

"They can determine what parts of the body are problem areas before you play golf, and they will create an individualized conditioning program," says Dr. Burg, who is a certified TPI golf expert. Cleveland Clinic has several certified golf experts, and you can also find one in your area on the TPI website (mytpi.com). Golf assessments are not usually covered by health insurance unless you have a golf-related injury.
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In The News: September 2019

Osteoarthritis develops when cartilage (the cushioning material that covers the ends of bones in joints) deteriorates. The reason this happens is not entirely understood, but several factors, including certain injuries, can increase the risk. A study published in the British Journal of Sports Medicine (May 2019) examined the connection between knee injuries and osteoarthritis. The researchers reviewed results of 53 studies that included a total of about 1 million adults who had an injury of the anterior cruciate ligament (ACL), an injury of the meniscus or a combination of knee injuries. (The ACL is a ligament in the knee, and the meniscus is a C-shaped piece of cartilage between the two bones at the knee.) The odds of developing knee osteoarthritis were more than four times higher following an ACL injury and more than six times higher after a meniscal injury or combination of injuries.
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