Bones and joints Archive

For many women, bunions and rigidity are two of the most common—and painful—problems with the big toe. Both are easily treated.

Men also get osteoporosis—but consider your risk factors before deciding to have a bone-strength test.

Men's and women's bodies differ in plenty of ways, but we all have bones, and with aging they may lose some of their strength and leave us more vulnerable to dangerous fractures of the hip or spine. Osteoporosis is not exclusively a women's health issue.

Q. I have sciatica. I also have vertebral fractures caused by osteoporosis. I'd like to get physical therapy for my sciatica but am worried about damaging my spine further. What do you advise?

A. I am glad that you are interested in pursuing physical therapy to treat the sciatica. It's the best treatment for it. The physical therapist is likely to show you how to do gentle stretching exercises for your upper legs, buttocks, and back, as well as how to use your back, core, and legs more effectively to avoid worsening the strain on your sciatic nerve. She will also train you to do exercises to strengthen your back and core. None of these maneuvers will damage the bones in your back. But it's important for you to tell the therapist that you do have osteoporosis and vertebral fractures. She will keep that in mind as she works with you.

Physical therapy is helpful for wear-and-tear knee osteoarthritis, especially if you start doing it early. But injecting a painful knee with an anti-inflammatory steroid medication before starting physical therapy offers no additional benefit, according to a clinical trial in JAMA Internal Medicine.

Studies have shown that physical therapy modestly reduces pain and improves daily functioning in people with knee osteoarthritis. That could mean being able to walk farther with less pain or to continue leisure activities such as gardening. Before you start physical therapy, your doctor may offer to inject the knee with a cocktail of anti-inflammatory steroid medication and an anesthetic. Hypothetically, this could make it easier for you to stick with exercise and therefore lead to better results.

Knee replacements can restore your mobility, but you don't want to get one too soon—or wait too long.

Painful knees and sleeplessness often go hand in hand, but a form of counseling called cognitive behavioral therapy (CBT) can help with both problems, according to a study in Arthritis and Rheumatology.

The study involved 100 people ages 50 to 70 with wear-and-tear arthritis (osteoarthritis) in the knee as well as insomnia. They were chosen at random for either eight sessions of CBT or a comparison treatment, called desensitization therapy, known not to be very effective for insomnia.

A study published online April 13, 2015, in JAMA Internal Medicine indicates that a single infusion of the bisphosphonate drug zoledronate (Reclast) can be used to increase bone density in women who can't take oral versions of bisphosphonates. Taking an oral bisphosphonate like alendronate (Fosamax) is effective in building bone for women with osteoporosis, but it requires a commitment—taking the drug on an empty stomach and remaining upright for 30 minutes afterward. Because this may not be practical for women in assisted living facilities, they often aren't given bone-building drugs, even though their risk of hip fracture is eight to nine times that of women living at home.

The researchers studied 181 women with osteoporosis residing in assisted living facilities. The average age was 85. The women were randomly assigned to one of two treatments—1,200 milligrams of calcium and 800 IU of vitamin D daily as supplements plus a single intravenous infusion of zoledronate or the same daily doses of the supplements alone.

Physical therapy and weight loss can relieve knee pain and protect your mobility.

A strong or weak hand grip carries more than just social cues. It may also help measure an individual’s risk for having a heart attack or stroke, or dying from cardiovascular disease. As part of the international Prospective Urban and Rural Epidemiological (PURE) study, researchers measured grip strength in nearly 140,000 adults in 17 countries and followed their health for an average of four years. Each 11-pound decrease in grip strength over the course of the study was linked to a 16% higher risk of dying from any cause, a 17% higher risk of dying from heart disease, a 9% higher risk of stroke, and a 7% higher risk of heart attack. Interestingly, grip strength was a better predictor of death or cardiovascular disease than blood pressure. What’s the connection? It’s possible that grip strength measures biological age.

A few simple measures can protect your most flexible joint and put it back in service after overuse or injury.

All you need to do is rotate your arm to realize what a marvel your shoulder is. It's the body's most flexible joint and one of the most essential. Whether you're reaching the top shelf, swinging a golf club, or washing your hair, "it's the one joint you can't stop using," says Karen Weber, a physical therapist at Harvard-affiliated Spaulding Rehabilitation Network. "We do a lot of repetitive motions with our arms. When our shoulder muscles aren't strong, we can set ourselves up for injury," Weber says.