Pain Management

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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Download The Full September 2019 Issue PDF

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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Can AI Fix Your Bad Back?

There also is a wealth of data in medical records and the research literature about the characteristics of individual patients and their experiences with different treatments. "When I'm in an exam room with a patient, it is difficult to reconcile the hundreds of data points in the records that influence how a patient will perceive their outcome and to render a truly informed decision for that patient," says Dr. Mroz. He believes the solution to this problem is artificial intelligence (AI).
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Biceps Tendon Injury

There are two biceps tendons at the shoulder, called the long head and short head. "The long head of the tendon is deep in the shoulder, and it passes out of the shoulder joint into a little groove at the top of the humerus bone," explains Dr. Schickendantz. This lengthy pathway makes the long head of the biceps tendon more prone to injury than the short head.
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Choose Healthy Snacks

To keep weight in check, healthy food choices matter. That includes all the food you eat. Your carefully planned diet can go astray with some unwise snacking. "I recommend a Mediterranean way of eating in general for both meals and snacks," says Cleveland Clinic dietitian Mira Ilic, RD, LD.
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JAK Inhibitors for Rheumatoid Arthritis

Drugs for rheumatoid arthritis work by blocking parts of the immune system from wreaking havoc. Most people with rheumatoid arthritis start with the disease-modifying antirheumatic drug (DMARD) methotrexate, usually taken as a pill (but is also available as an injection). It has a proven track record as an effective medication. There are other DMARDs as well. Methotrexate doesn't work well enough for everyone, and some people have side effects.
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Ask The Doctors: September 2019

If not enough uric acid is excreted (a function of the kidneys) it can build up in the bloodstream and cause hyperuricemia. Some people, but not all, who have hyperuricemia will develop gout. In people with gout, uric acid leaves the bloodstream and travels to joints. The deposits of uric acid can intermittently form needle-shaped crystals, which set off an inflammatory response by the body. The result is a red, hot and swollen joint of a gout attack.
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Who Treats Arthritis?

If the doctor suspects there might be some other cause of joint problems besides osteoarthritis, a rheumatologist will be consulted. If symptoms of osteoarthritis don't improve or get worse, your doctor may send you to an orthopaedist or a rheumatologist for more intense medical management or an orthopaedic surgeon for surgery.
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