Gout: Sleep apnea may raise your risk

Matthew Solan
Matthew Solan, Executive Editor, Harvard Men's Health Watch

Sleep apnea is a disorder that causes people to stop breathing for short periods during sleep. It is linked to several chronic health problems, including heart disease and high blood pressure. A recent study suggests that sleep apnea may also raise the risk for gout, a common form of inflammatory arthritis. This is just one more good reason to talk with your doctor if you have symptoms of sleep apnea (which include loud snoring and excessive sleepiness during the day).

Can depression worsen RA symptoms or make treatment less effective?

Bonnie Bermas, MD
Bonnie Bermas, MD, Contributing Editor

Depression is fairly common among people suffering with rheumatoid arthritis (RA). Recent research suggests that depression may worsen RA symptoms and even make medications less effective. To date, the studies that indicate a connection between the severity of RA symptoms and depression have not been conclusive, so more research is needed. In the meantime, if you have RA and notice signs of depression, be sure to talk with your doctor.

Acupuncture for knee arthritis fails one test but may still be worth a try

Daniel Pendick
Daniel Pendick, Former Executive Editor, Harvard Men's Health Watch

A report published this week in the Journal of the American Medical Association offers weak-to-no proof that acupuncture helps ease the pain of knee arthritis. In a group of older men and women with arthritis-related knee pain, Australian researchers compared traditional needle acupuncture against laser acupuncture, sham laser acupuncture, and no treatment. People who had needle or laser acupuncture reported slightly less pain and slightly better physical function compared with the group that had no treatment at all. Sham acupuncture worked as well as real acupuncture, suggesting the placebo effect may be at work.

Insoles no help for knee osteoarthritis

Stephanie Watson

Nearly a third of Americans will develop osteoarthritis of the knee before age 70. With no “cure” beside knee replacement on the horizon for this painful joint condition, relief often has to come from pain pills. Assistive devices such as wedge insoles are often prescribed as a less drastic, side effect-free treatment option. But do they really work? A review of research published today in JAMA indicates that these shoe inserts do little—if anything—to relieve arthritis pain. The findings echo new osteoarthritis treatment guidelines released by the American Academy of Orthopaedic Surgeons (AAOS) in May. Based on current research, the AAOS said it couldn’t recommend lateral wedge insoles for people with medial knee osteoarthritis.

Exercise is good, not bad, for arthritis

Patrick J. Skerrett, Former Executive Editor, Harvard Health

When pain strikes, it’s human nature to avoid doing things that aggravate it. That’s certainly the case for people with arthritis, many of whom tend to avoid exercise when a hip, knee, ankle or other joint hurts. Although that strategy seems to make sense, it may harm more than help. Taking a walk on most days of the week can actually ease arthritis pain and improve other symptoms. It’s also good for the heart, brain, and every other part of the body. Yet a new survey from the Centers for Disease Control and Prevention shows that more than half of people with arthritis don’t walk at all for exercise, and only 23% meet the current recommendation for activity—walking for at least 150 minutes a week. Walking is good exercise for people with arthritis, but it isn’t the only one. A review of the benefits of exercise for people with osteoarthritis (the most common form of arthritis) found that strength training, water-based exercise, and balance therapy were the most helpful for reducing pain and improving function.

Physical therapy works as well as surgery for some with torn knee cartilage

Patrick J. Skerrett, Former Executive Editor, Harvard Health

Tiny shock absorbers in the knee (each one is called a meniscus) provide a key cushion between the thighbone and the shinbone. They are prone to tearing, and sometimes just wear out. A torn meniscus can cause pain or other symptoms, like a knee that locks. But sometimes they don’t cause any symptoms. In a youngish person, when a knee-wrenching activity like skiing, ultimate Frisbee, or slipping on the ice tears a meniscus, the damage is often repaired surgically. But a torn meniscus is often seen in the 9 million Americans with knee osteoarthritis, and for them the best course of action hasn’t been crystal clear. Results of the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial published yesterday in the New England Journal of Medicine indicate that physical therapy may be just as good as surgery. Both therapies led to similar improvements in knee function and pain at six and 12 months.

Rub-on pain reliever can ease arthritis discomfort

Daniel Pendick
Daniel Pendick, Former Executive Editor, Harvard Men's Health Watch

When it comes to relieving the pain of achy joints, many people reach for a pain-relieving pill like aspirin or ibuprofen. There may be a better way. When the source of pain is close to the surface, applying a cream, gel, patch, or spray that contains a pain reliever right where it hurts can ease pain and help avoid some of the body-wide side effects of oral pain relievers. These so-called topical analgesics work best for more superficial joints like the knees, ankles, feet, elbows, and hands. The active ingredient in most topical analgesics is a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen, naproxen, aspirin, or diclofenac. These medications target inflammation, which contributes to pain, swelling, and stiffness. The advantage of using a topical analgesic is that the medication works locally. Targeting pain more precisely using a medication applied to the skin can help skirt the side effects of oral drugs. This can be a boon for people whose stomachs are sensitive to NSAIDs.

Common painkillers boost risk of repeat heart attack

Howard LeWine, M.D.
Howard LeWine, M.D., Chief Medical Editor, Internet Publishing, Harvard Health Publications

Most people don’t think twice about taking Motrin, Advil, Aleve, or similar over-the-counter painkillers. A new study suggests that heart attack survivors should use these drugs, known as nonsteroidal anti-inflammatory drugs (NSAIDs), as little as possible. A team of Danish researchers found that among heart attack survivors, those who used an NSAID were about 60% more likely to have died during each year of the five-year study than those who didn’t use an NSAID. Of all the NSAIDs, diclofenac (Cataflam, Voltaren, generic) was linked to the largest increases in death or heart attack rates, while naproxen (Naprosyn, Aleve, generic) appeared to carry the lowest risk. The lower risk with naproxen confirms what has been seen in older studies. If you have heart disease and need pain relief, try acetaminophen first. If you need an NSAID, naproxen is probably the best choice for your heart. But whatever you and your doctor decide is best for you, use the lowest dose possible for the shortest period of time.

Increase in heart attack risk after joint surgery low but persistent

Daniel Pendick
Daniel Pendick, Former Executive Editor, Harvard Men's Health Watch

A recent study in the Archives of Internal Medicine indicates that the risk of having a heart attack is up to 31 times higher immediately following joint replacement surgery. Those relative risk numbers could be terrifying for someone who needs to have a knee or hip replaced. The absolute risk numbers offer some reassurance. In the six weeks following surgery, one in 200 people in the study who got a new hip and one in 500 who had a knee replaced suffered a heart attack. One new point the study underscored is that the elevated risk may last longer than previously thought. Though earlier research had suggested a danger zone lasting four to five days after joint replacement—coincidentally, the period in which many people are discharged from the hospital—the elevated heart attack risk may persist for two to six weeks.

Chicken Soup for the Soul and Harvard Health serve up inspiration, information

Julie Silver, M.D.
Julie Silver, M.D., Chief Editor of Books, Harvard Health Publications

A new series of books is bringing readers the kind of inspirational stories that have made Chicken Soup for the Soul books international bestsellers plus with trusted health advice from Harvard Medical School. The combination of stories providing hope, inspiration, and great person-to-person advice plus straight talk and life-changing medical information from Harvard doctors will help readers live healthier, more satisfying lives. Each book focuses on a single topic. The first four will be available beginning May 22, 2012. They are Chicken Soup for the Soul: Boost Your Brain Power! by top neurologist Dr. Marie Pasinski; Chicken Soup for the Soul: Say Goodbye to Back Pain! by leading physical medicine expert Dr. Julie Silver; Chicken Soup for the Soul: Say Goodbye to Stress! by noted psychologist Dr. Jeff Brown; and Chicken Soup for the Soul: Say Hello to a Better Body! by respected internist Dr. Suzanne Koven.