Arthritis

Is there a “best” pain reliever for osteoarthritis?

Robert R. Edwards, Ph.D.
Robert R. Edwards, Ph.D., Contributing Editor

Osteoarthritis can contribute significantly to a reduced quality of life, and many arthritis sufferers have come to rely on pain medication for symptom control. A recent study compared NSAIDs against opioids for pain relief and found no significant difference between them. But as always, the right treatment choice for any individual person depends on their unique medical situation and what works best for them.

The “right” goal when managing pain

Robert R. Edwards, Ph.D.
Robert R. Edwards, Ph.D., Contributing Editor

When it comes to pain management, focusing only on reducing the intensity of pain may lead to treatments that do as much harm as good. Ideally, pain-management plans should be tailored to each patient and include a range of therapies that not only reduce pain but also help improve pain-related quality-of-life problems.

Can the weather really worsen arthritis pain?

Robert H. Shmerling, MD
Robert H. Shmerling, MD, Faculty Editor, Harvard Health Publications

Many arthritis sufferers notice a link between the weather and their symptoms. Research supports a connection, though the precise causes and effects aren’t clear. While there is little one can do to control the weather, there is a lot that can be done to relieve the pain and stiffness of arthritis. Don’t put up with arthritis symptoms in any weather — see your doctor to discuss treatment options.

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.