News March 2007 Issue

In The News: 03/07

Popular Heartburn Drugs Linked To Hip Fractures

Nexium, Prevacid, and Prilosec members of a class of drugs known as proton pump inhibitors and used for heartburn (acid reflux) relief by millions today have been found to be associated with an increased risk of hip fracture in the elderly. Using a universal database, researchers at the University of Pennsylvania School of Medicine examined the medical records of more than 145,000 British patients over age 50. Patients who used the drugs for more than a year had a 44 percent higher risk of hip fracture than non-users. Long-term users who received high doses of the drugs had as much as 2.6 times the normal risk. Researchers speculated that while the drugs lower a stomachís acidity levels, they also make it more difficult for the body to absorb calcium, which can lead to weaker bones. Men using the drugs had about twice the risk of hip fractures as the women; investigators conjectured that women were more likely to be consuming calcium supplements as part of a post-menopausal therapy. The study also found a similar but smaller risk (21 percent increase) of hip fractures for another class of acid-fighting drugs called H2 blockers (Tagament, Pepcid, Zantac, Axid).

Psychological Treatments Improve Back Pain

Psychology can play an important role in not only relieving the depression that back-pain sufferers often experience, it can reduce the pain as well. Investigators looked at 22 randomized trials that examined adults with nonmalignant lower-back pain that had persisted for at least three months. The trials included a variety of psychological approaches, including hypnosis, biofeedback, relaxation, and counseling. In the broadest analysis, researchers found that psychological interventions were superior to standard treatments in reducing pain intensity. The discovery was surprising, since the goal of psychological intervention has traditionally been to help patients live with their pain more successfully.

Researchers concluded that psychological interventions are also more cost-effective, especially when compared to other back-pain treatments surgery, opioids, nerve blocks, spinal cord stimulators that have driven the estimated range of treatment-related costs in the U.S. from $20 billion to $80 billion a year

Massage Can Reduce Pain, Increase Function In Knee OA

In a study of 68 men and women with osteoarthritis of the knee, Swedish massage was found to significantly improve pain, stiffness, function, and range of motion. Patients, average age 68, were randomized to either twice-weekly massage treatments or to a control group that underwent usual care (pain medications and hot or cold therapy). After 16 weeks the massage patients had maintained all the benefits they had experienced at eight weeks (no significant change was seen in the control group). Researchers concluded that, given the limitations and potential adverse effects of pharmacologic treatments for OA, such as nausea, constipation, dizziness and stomach irritation, massage therapy is a viable adjunct to more conventional OA treatments.

Exercise Better Than Calorie Reduction For Bone Strength

If your goal is to lose weight, and you want to maintain bone strength, do it through exercise rather than by trimming calories. Thatís the conclusion of a study that found that although one year of calorie restriction or exercise yielded similar weight loss, only weight loss from calorie restriction produced a significant decrease in bone-mineral density (BMD) in the hip and spine, two key points of fracture. The 12-month trial consisted of 48 men and women between ages 50 and 60 who were divided into a calorie-restriction group or exercise group. Those in the calorie-restriction group reduced their caloric intake by 16-20 percent over the 12-month period. By the end of the trial, investigators found that the calorie-restriction group had less BMD at the hip and spine, while those in the exercise group did not show any decrease in BMD at either site. Researchers suggested that exercise should always be adopted to offset the adverse effects of calorie restriction on bone strength.