Knees Archive

The strength of your hands may hold clues to the health of your heart. A study in the December 2015 American Journal of Preventive Medicine found that people with stronger handgrips had more favorable findings on measures of their cardiovascular health than those with weaker grips.

The study included more than 4,200 adults ages 20 and older who were part of a nationwide health study. Researchers used a device called a dynamometer to measure each participant's hand strength, adjusting the readings based on body mass index. They found that higher handgrip strength was associated with lower blood pressure, lower triglycerides (a type of fat in the blood), lower blood sugar, and higher HDL (good) cholesterol.

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Q. I occasionally use a brace on my knee because I have knee arthritis. Am I weakening my knee?

A. The benefit of a brace for knee arthritis is likely in the eye of the beholder. A brace can help improve the ability to perform certain activities, and for some people the compression and warmth of the brace relieves pain. However, medical research has been mixed on the absolute benefits.

If knee pain and swelling are severe an are not getting better, see your primary care doctor for a thorough evalucation. Image: Thinkstock

Arthritis is not the only possible cause of knee pain, swelling, and disability.

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Q. My right hand goes numb when I open a can or use hand tools. Is this something I need to worry about? Do I have carpal tunnel syndrome?

A. The hand receives its sensory information from three different nerves, and irritation of any of them can lead to numbness. In the hand, numbness is often related to the way that the nerve is compressed or squeezed slightly when you bend your wrist, as happens when you open a can. Excess vibration or repetitive hand motion when you use tools may also cause numbness.

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Q. I take warfarin for my atrial fibrillation. I know it can increase the risk of bleeding. Is it okay for me to take ibuprofen for my arthritis?

A. In general, you should avoid ibuprofen—which is sold as Advil, Motrin, and generics—while taking warfarin, because taking them together may further increase your risk of bleeding.

Joint replacement is a complex procedure, and finding the right surgeon and hospital can make a big difference in your outcome. In general, you're likely to have a better result and fewer complications if your surgeon performs the operation frequently (at least 100 times per year) and operates in a hospital where these procedures are commonplace. Don't be surprised if this rules out the most convenient hospital for your location.

Your orthopedist, rheumatologist, or primary care physician, or a friend who has undergone successful joint replacement, may be able to recommend a specific surgeon. But keep in mind that your insurer may restrict you to certain specialists or require a larger copayment if you go outside your plan.

Although vitamin D is essential to bone health, a controlled clinical trial published online by JAMA Internal Medicine on Aug. 3, 2015, found that vitamin D supplements didn't build bone in postmenopausal women with blood levels of vitamin D below the 30-ng/mL threshold generally considered necessary for good health. Researchers at the University of Wisconsin randomly assigned 230 women to three groups: one got 800 IU of vitamin D daily and a placebo twice a month; one got a placebo daily and 50,000 IU of vitamin D twice a month; the third got placebos both daily and twice a month. The study lasted a year. The researchers found that neither dose of vitamin D had a significant effect on bone mass, falls, or fractures.

The Wisconsin study may not have used the right doses of vitamin D or lasted long enough to show an effect. One ongoing study, The Vitamin D and Omega-3 Trial (VITAL), is large enough to demonstrate even small-to-moderate benefits of vitamin D supplementation. VITAL is evaluating a 2,000-IU daily dose for five years in 26,000 women and men. The results are expected in 2017. Until then, it's still important to get the recommended daily dose of vitamin D: 600 IU for adults through age 70 and 800 IU for people ages 71 or older