Subscriber Only

Download The Full June 2019 Issue PDF

When knee osteoarthritis worsens to a point where it can no longer be managed with nonsurgical measures, many people turn to joint replacement surgery. But there may be reasons to delay or avoid surgery. If thats the case, you arent necessarily out of luck. A genicular nerve block may help ease pain enough to get you back to functioning.

Ask The Doctors: June 2019

The number of osteoporosis drugs and the different ways they are taken can be confusing. There are pills, injections and infusions, taken weekly, monthly or at other intervals. Your doctor chooses the best drug based on a variety of factors. A small percentage of people who take bisphosphonates have gastrointestinal problems, such as nausea, stomach pain, constipation, diarrhea and gas. This may be one reason your doctor prescribed Prolia, which is given as an injection and is easier on the stomach.

Nerve Blocks for Knee Pain

Unlike with a corticosteroid shot, which is injected into the joint, the anesthetic that is injected for a nerve block stays outside the joint. "We want to target nerves before they dive into the knee," says Dr. Bolash. "If I wanted to cut off electricity to your house, I wouldn't go around to every lamp. I would cut it off before it gets into the house."

In The News: June 2019

People with osteoarthritis in the knee who add hip-strengthening exercises to their exercise regimen can walk more easily and may have less pain, according to a study published in the British Journal of Sports Medicine (February 2019). The researchers pooled results from eight studies (with a total of 340 participants) that investigated the effect of adding hip exercises to exercises done to strengthen the muscles on the front of the thigh (the quadriceps). They found that combining the two types of exercises was significantly more effective than quadricep exercises alone for improving walking. The most effective types of hip exercises involved using weights or resistance bands. Adding hip exercises also resulted in greater improvements in pain, but this result was not significantly strong. Physical therapists can provide instruction on simple exercises to strengthen hips and knees.

Real-Food Diet

I often have leftovers from the previous night's dinner, like stew or vegetables. It usually contains some beans, tofu, chicken or fish. Or an avocado, sprinkled with salt, or a bowl of homemade soup and a couple pieces of fruit. Afternoon snack consists of nuts (any and all kinds), a piece of fruit and a piece of dark chocolate. I keep a small knife and cutting board at work to slice up things like tomatoes and cucumbers.

Something to Lean On

When using an assistive device, you should keep the alignment of your body as normal as possible. If you bend forward at the hips, it decreases your ability to push off and propel your body forward. The exception is people with pain in the low back that radiates down the legs, which can stem from nerve irritation. For these people, bending slightly forward relievespain.

Risks of Keeping Cancer in Check

A few years ago, Cleveland Clinic rheumatologist Casandra Calabrese, DO, began seeing patients who were being treated for cancer and had developed the type of joint pain and swelling seen in rheumatoid arthritis. She isn't alone. Rheumatologists around the world are treating such patients. What is going on?

Download The Full May 2019 Issue PDF

When advanced osteoarthritis in the shoulder results in pain and loss of function, and nonsurgical treatments no longer help, joint replacement surgery may become anoption.

Ask The Doctors: May 2019

Osteoarthritis starts when cartilage (the covering over the ends of bones in joints that allows for smooth movement) breaks down and thins. This leads to damage to other structures in and around the joint and inflammation. This causes joint pain, stiffness and swelling. Symptoms often start slowly and get worse over time.

New Life for Shoulders

Reverse shoulder replacement is similar to the anatomic version, except the positions of the two components of the implant are reversed. "We put the ball on the socket side and the socket on the ball side," says Dr. Entezari. This solves the problem of not having rotator cuff muscles to keep the joint stable because the socket can be made deeper and the two parts of the implant are linked.

In The News: May 2019

Joint replacement surgery is an option for people with severe osteoarthritis in the hip or knee that can no longer be helped with nonsurgical measures. The surgery has a high success rate. However, over time the implants eventually fail due to loosening, infection, instability and other reasons.

Start Moving in May

Consider seeing a physical therapist who can tailor an exercise program to your particular needs. In general, you'll benefit from some combination of aerobic, resistance and performance exercises. Aerobic exercises get your heart beating faster and are good for heart health. Resistance exercises focus on muscle strength. Performance exercises improve your ability to perform particular activities and include balance exercises.