Pain Archive

Men may avoid activity because of their knee pain, but movement is exactly what they need.

It is perhaps the ultimate exercise catch-22: it's hard to move with knee osteoarthritis, but moving helps relieve osteoarthritis knee pain.

More than 30 million Americans have osteoarthritis, the most common kind of arthritis. While osteoarthritis can affect the hips, lower back, neck, and fingers, it occurs most often in the knees. In fact, an estimated 10% of men ages 60 and older have symptoms of knee osteoarthritis.

News briefs

Are you taking a medication that has depression or suicidal thinking as a potential side effect? One or both risks have been linked to use of more than 200 prescription and over-the-counter pills, including medicines that treat high blood pressure, heartburn, pain, and headaches. The more of these drugs you use, the higher the likelihood that you'll experience depression, suggests a study published June 12, 2018, in The Journal of the American Medical Association. Working with five surveys conducted over a nine-year period, researchers evaluated health information from 26,192 adults. About 37% of them reported taking such medications. Of individuals taking three or more of the medications with depression as a possible side effect, about 15% reported depression, compared with about 5% in people not using those medications. Even for people already taking an antidepressant, the addition of one or more of the identified medicines was linked to higher rates of depression. This study was based on surveys, so it didn't prove that the medications caused the reported depression. Nonetheless, if you think you're depressed (and have symptoms such as apathy, hopelessness, changes in sleep or eating habits, and persistent fatigue), ask your doctor if any of the medicines you are taking may be responsible.

Image: © Tero Vesalainen | GettyImages

Art therapy can be an effective way to help manage pain.

 Image: © Zinkevych/Getty Images

If you deal with pain from an injury, surgery, or just daily life, you may want to make some art.

Art therapy is a form of expressive therapy that taps into parts of the brain involved in the creative process. And this can help modify your response to emotional and physical concerns.

In the journals

If you suffer from low back pain and want to avoid taking strong pain medication, you might want to consult a physical therapist first, suggests a recent study published online May 23, 2018, by Health Services Research.

Researchers reviewed insurance claims for approximately 150,000 adults, ages 18 to 64, who had been newly diagnosed with low back pain. They found that those who first consulted a physical therapist had an 89% lower probability of receiving an opioid prescription compared with those who saw another type of medical provider. They were also less likely to have an MRI or CT scan or to seek out emergency care for their pain.

News briefs

Encouraging news for people who suffer with migraines: in May, the FDA approved erenumab (Aimovig), the first medication aimed at preventing these debilitating headaches. Current medications to treat migraines were actually designed to control other conditions, such as seizures or an irregular heartbeat; their side effects (like sexual dysfunction and fuzzy thinking) often cause people to skip treatment. Erenumab offers a new approach. Injected once a month, it works by blocking a molecule (calcitonin gene-related peptide) involved in migraine attacks, and compared with other drugs, it appears to have fewer side effects (primarily constipation and injection site reactions). "This drug is for people who have more than four migraines per month, but it won't take migraines away entirely," says Dr. Gad Marshall, a neurologist at Harvard-affiliated Brigham and Women's Hospital. Clinical trials suggest it can reduce frequency by one or two migraines per month, or even more in some people. "For people with frequent debilitating migraines it could be a game changer," says Dr. Lee Schwamm, a neurologist at Harvard-affiliated Massachusetts General Hospital. "But erenumab is expensive, and it will take time to find out if it's effective and safe over the long term."

Ask the doctors

Q. My friend was recently diagnosed with fibromyalgia, but it seems like she might be imagining her symptoms. Is fibromyalgia a real condition?

A. The short answer to your question is yes. Fibromyalgia is a real condition that affects some four million Americans. It's a chronic pain syndrome that experts believe may be caused by a malfunctioning nervous system. Researchers using magnetic resonance imaging to examine the brains of people with fibromyalgia have found abnormalities in the part of the brain that processes pain signals from the body. It appears that this part of the brain is essentially boosting the intensity of normal pain signals, potentially causing the body to feel pain without a physical cause.

The foods you eat (and don't) can determine how well your body fights painful inflammation.

 Image: © autumnhoverter/Getty Images

It's been said that you are what you eat, and that's definitely true when it comes to chronic pain.

"A lot of chronic pain is the result of chronic inflammation, and the evidence is quite strong that your diet can contribute to increased systemic inflammation," says Dr. Fred Tabung, a visiting researcher with the Department of Nutrition at Harvard's T.H. Chan School of Public Health. "But your diet is also one of the best ways to reduce it."

We all experience pain in our lives, but can the cure be worse than the condition? In this seminar, Harvard Medical School experts explore the science of pain, the realities of prescription drug dependence and new discoveries and treatments that may lead to better, safer pain management.

Each spring, Harvard Medical School's Office of Communications and External Relations organizes a series of four free "mini-med school" classes for the general public in the heart of Boston's Longwood Medical Area. At the end of the seminar series, participants who attend three out of the four sessions receive a certificate of completion. Topics are selected for their appeal to a lay audience and have included the human genome, nutrition, sleep dynamics and health care access. Faculty from Harvard Medical School and its affiliate hospitals volunteer their time to present these lectures to the community.

News briefs

When you have a type of heel pain known as plantar fasciitis, you may hear that getting a custom-made orthotic (an insole molded to your heel or your whole foot) can help ease your agony. But a study published online March 19, 2018, by the British Journal of Sports Medicine suggests that custom orthotics — which can run a few hundred dollars — are no more helpful than less expensive over-the-counter versions, which cost about $20 or less. Plantar fasciitis is an inflammation of the plantar fascia, a band of tissue that extends along the bottom of the foot from the heel to the toes. It's associated with flat feet, a lack of flexibility, and overuse. Researchers analyzed 20 randomized controlled studies (the gold standard in research) that included about 1,800 people and eight different types of foot orthotics. Scientists found no difference in short-term pain relief among people who used custom-made orthotics compared with people who used store-bought versions. They also found that orthotics weren't better at relieving pain or improving function compared with other treatments for heel pain, such as stretching, wearing a heel brace, or using a splint at night. Plantar fasciitis often gets better with time as well as rest, ice, over-the-counter painkillers, and exercises to improve calf strength.