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Best ways to cope with hand pain

Aches or numbness may keep you from doing the things you love. Find out what's behind your pain, and do something about it.

Hand pain becomes common as we get older. Tingling and numbness, aching or locking joints, and difficulty grasping objects are frequent complaints. But don't make your own diagnosis and suffer in silence. "It's difficult to discern between different types of hand pain. Some have overlapping symptoms," says Dr. Sang-Gil Lee, a hand surgeon at Harvard-affiliated Massachusetts General Hospital.

Dr. Lee advises that you seek treatment as soon as possible for persistent hand pain, before it gets so advanced that it's tough to use your hands for even the simplest jobs, like brushing your teeth or buttoning a shirt.

Turning your back on back surgery

Men considering surgery for back pain relief may benefit from more conventional treatment methods.

Back pain remains one of the top reasons people seek medical care for pain. For many older men, the source of their pain is spinal osteoarthritis.

Finding relief is an ongoing struggle, but men should think hard before turning to surgery without first trying less invasive treatments. "No one ever goes from initial back pain to needing surgery, unless the pain is due to something like cancer or an infection," says Dr. Steven Atlas, an internist with Harvard-affiliated Massachusetts General Hospital. "You can't fix arthritis. Surgery may help control the pain in some cases, so you can function better, but it won't cure your pain — no matter what doctors may promise."

Are you at risk for gout?

This common type of arthritis can show up suddenly and cause debilitating pain.


 Image: © ThamKC/Thinkstock

The great artists Ludwig van Beethoven, Luciano Pavarotti, and Leonardo da Vinci had more than extraordinary talent in common; they were also sufferers of a type of inflammatory arthritis called gout. You may be at risk of joining their ranks if you have any potential triggers for the condition. "Most people are surprised by their initial gout diagnosis, unless they have a strong family history," says Dr. Mark Fisher, a rheumatologist at Harvard-affiliated Massachusetts General Hospital.

About gout

Gout is mostly a man's condition, although women can experience it, too. It's caused by a buildup of uric acid — a waste product from the breakdown of natural chemicals called purines (an essential part of DNA).

Just 45 minutes of weekly activity may help with arthritis

In the journals

Studies have shown that regular activity can help older adults with arthritis stay independent. How much is enough? Research published online Dec. 28, 2016, by Arthritis Care & Research suggests you may need as little as 45 minutes per week.

Federal guidelines recommend 150 minutes of moderate activity per week to prevent premature death and serious illness. However, reaching that number is tough to reach for people with arthritis; in fact, only one in eight men with knee arthritis meet this standard. In this study, researchers tracked several years of fitness activity for 1,629 adults (44% of whom were men), ages 49 to 83, with osteoarthritis in the hip, knee, foot, or some combination. Specific exercises or activities were not recorded, only the time invested per week.

Could that joint pain be rheumatoid arthritis?

How to distinguish the symptoms from other conditions, and what to do about treatment.


 Image: © PositiveFocus/Thinkstock

When your joints ache, you may chalk it up to an old injury or to osteoarthritis — the wearing away of cartilage that's common in older age. But for two million people in the United States, aching joints are caused by rheumatoid arthritis (RA) — when the immune system mistakenly attacks the tissues lining the joints.

"People commonly assume RA pain is due to aging, overuse, or even the flu," says Dr. Robert Shmerling, a rheumatologist at Harvard-affiliated Beth Israel Deaconess Medical Center, and medical editor of the Harvard Special Health Report Rheumatoid Arthritis (health.harvard.edu/RA).

Anti-inflammatory diet could reduce risk of bone loss in women

Research we're watching

Because several studies have connected inflammation to bone loss and fractures, researchers from Ohio State University wondered if dietary choices that contribute to inflammation are also related to declines in bone density.

The team looked at the diets of 160,191 postmenopausal women enrolled in the Women's Health Initiative and assigned each of them a dietary inflammation score based on 32 foods the women reported consuming in the three months prior to their enrollment. All the women completed dietary questionnaires and had scans to measure bone density at the beginning of the study and three and six years later.

Can you virtually improve your knee pain?

A study of people with osteoarthritis of the knee found that at the end of the study period, those participants who received more personalized attention via the web (including physical therapy sessions and information about pain management) had less pain and better movement function.

Is there hope for leg cramp sufferers?

Despite the lack of a universally recognized therapy for nighttime leg cramps, a few approaches may be worth trying.


Image: Monkey Business Images/Thinkstock

Few things are more jarring to a night's sleep than shooting calf pains. If you have nocturnal leg cramps, you have lots of company. Although they can strike people at any time of life, they become more common with age. Among people over 60, almost half report having leg cramps, a third say they are awakened by cramps at night, and 15% report weekly episodes.

What causes leg cramps?

Preventing cramps

There are no FDA-approved medications for leg cramps, and the U.S. Preventive Services Task Force hasn't issued guidelines for treating them. However, the American Academy of Neurology (AAN) has issued the following advice on common therapies, based on scientific evidence of effectiveness.

Stretching exercises. The AAN says that there are not enough data to say for sure that stretching helps reduce the frequency of muscle cramps. That doesn't mean that the exercises are ineffective or harmful, and doing them can help contribute to the flexibility of your legs.

Quinine. There is solid evidence that quinine and quinine derivatives are effective in reducing the frequency of muscle cramps, although the magnitude of benefit is small. However, quinine is out-of-bounds for most people. The FDA has issued repeated warnings against using quinine (which is approved only to treat certain types of malaria) to prevent or treat leg cramps because it may cause serious side effects, including bleeding and kidney damage. Although doctors can still prescribe quinine, it is recommended only when cramps are disabling and when the person can be carefully monitored for side effects.

Vitamin B complex. There is some evidence that taking a daily capsule containing eight B vitamins—B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6, B7 (biotin), B9 (folate), and B12—may prevent cramps.

Calcium-channel blockers. Evidence indicates that one calcium-channel blocker—diltiazem (Cardizem, Dilacor XR)—is possibly effective.

Ineffective therapies. The AAN found enough evidence to indicate that magnesium supplements and gabapentin (Neurontin) aren't likely to help.

Other remedies

In situations like nighttime leg cramps, where there are no widely accepted treatments, unproven remedies may be worth a try. The following are low-risk and have enthusiastic proponents.

  • Soap. If you don't mind sharing the bed with a bar of soap, you might want to try securing one under the bottom sheet near where your legs usually rest. Despite scores of testimonials to its effectiveness in letters to news media and comments on websites, no one has offered a hypothesis for how soap might work. Yet it's inexpensive and harmless.

  • Mustard or pickle juice. Swallowing a teaspoon of mustard or an ounce of pickle juice before bedtime also has enthusiastic advocates. In fact, the pickle juice preventive has become a staple among athletes who want to avoid being sidelined by cramps. However, if you have gastroesophageal reflux disorder or are trying to cut back on salt, you might want to check with your doctor before trying this approach. Scientists think the foods might stimulate ion channels in the mouth, esophagus, and stomach to send signals to the central nervous system that inactivate overexcited neurons.

  • HotShot . This 1.7-ounce dose of cinnamon, ginger, lime juice, sweeteners, and capsaicin (the active compound in chili peppers) was developed by Dr. Bean and Dr. Rod MacKinnon, a Nobel Laureate in Chemistry at Rockefeller University, as a remedy for cramping during rigorous exercise. It works along the same principle as mustard and pickle juice, but has longer-lasting effects. It is currently available commercially as a sports beverage. "Although I am aware of people using it for nocturnal leg cramps, it has not yet been formally tested for that use," Dr. Bean says.

Boning up on osteoporosis

The disease strikes more women, but men are also at risk.

Osteoporosis is often considered a woman's disease, but men also need to be concerned about this bone-weakening condition. About 2 million men have osteoporosis and another 12 million are at high risk, according to the National Osteoporosis Foundation.

In fact, older men have a greater risk for an osteoporosis-related fracture than for getting prostate cancer, and about one in four men older than 50 will break a bone because of osteoporosis during his lifetime.

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