Pain Archive

Q. I have had arthritis of the knee for many years, and I prefer not to take medications for the pain. Can acupuncture help?

A. Acupuncture has been promoted for many conditions, but the results for knee arthritis have been mixed. A recent study in The Journal of the American Medical Association showed that acupuncture had a small benefit compared with no treatment in people with knee arthritis. However, when compared with a simulated or "sham" acupuncture treatment; real acupuncture was not more effective. A larger study published in 2006 with more than 1,000 people showed a similar finding.

Try conservative measures first to control pain, and know the limits and risks of cortisone  shots if you choose to try it.

Most people who suffer with back pain already know the drill: time heals this wound. Over weeks to months, the pain will calm down, and you will slowly return to your normal life. In the meantime, try to stay as active as possible and rely as much as possible on over-the-counter pain relievers to help avoid needing cortisone shots. Doctors call these shots corticosteroid injections.

But for some, these conservative measures may not relieve the agony soon enough—especially if the problem is back pain caused by irritated spinal nerves. After a few weeks, just getting to the bathroom may start to feel like Napoleon's winter march in Russia. At that point, you may be offered a cortisone injection to calm the war zone in your lower back.

Arthritis is a painful problem that can interfere with your ability to do the things you enjoy. But you can take steps to manage arthritis by protecting your joints, reducing discomfort, and improving mobility.

Physical or occupational therapists can be very helpful in teaching you how to modify activities and accomplish daily tasks more easily in order to manage arthritis. But there are simple things you can do for yourself, starting today. Here are five of them:

There's more to optimizing care than pain medication. See a hand therapist to obtain a personalized strategy.

Wear-and-tear osteoarthritis is very common in the knees and hips, but it strikes the hands, too. When the cushioning cartilage within the finger joints begins to break down, leading to pain and inflammation, all the usual remedies apply, such as appropriate use of medication.

Q. I am 61 and had been on atorvastatin for 10 years with no problems. Recently, I've had disabling muscle pain with both the generic atorvastatin and the brand-name version, Lipitor. My doctor says that I can no longer take statin drugs. Since strokes run in my family, I am concerned. Is there anything else I can do to decrease my risk of stroke?

A. You need to have a detailed conversation with your doctor. First, it's important to know what kind of reaction you had to the atorvastatin. Was it rhabdomyolysis? That's a serious medical problem that involves destruction of muscle tissue. As muscle cells die, they release high levels of the enzyme creatine kinase, or CK, into your blood, which can damage your kidneys. Or was it statin-induced myalgia? That condition usually causes weakness and soreness in your upper arms and thighs and can make it difficult to raise your arms above your head, get out of a chair, or climb stairs. Could it have been myopathy, which includes any of the muscle symptoms mentioned above plus a significant elevation in blood levels of CK? The severity of your reaction to the atorvastatin will determine what to do next.

Hand pain and stiffness, often tolerated without medical attention, can be successfully treated.

If you've ever awakened with numb hands, had your finger lock while filling out a crossword puzzle, or tried in vain to open a jar, you know what it's like to have your hands fail you. Yet you don't have to accept discomfort and disability as a consequence of aging. There are a host of treatments that can alleviate pain and improve function with minimal recovery time.

Botulinum toxin is also an effective treatment for muscle spasms, migraine headaches, incontinence, and more.

You've no doubt witnessed the effect of Botox in the unfurrowed brows of celebrities. But Botox's applications are more than skin deep; the drug has a role in treating disorders that range from migraine headaches to incontinence.

The first advice you are likely to get if you have low back pain is "take a Tylenol." However a study published July 24, 2014, online by the journal Lancet indicates that you might do just as well without Tylenol, Panadol, or any of the other pain relievers containing acetaminophen.

Acetaminophen has long been recommended as first-line treatment for low back pain, but there wasn't much research to indicate how well it worked

Acetaminophen (Tylenol) does not help people recover from new episodes of back pain, according to a clinical trial in The Lancet. The study involved 1,652 people with new back pain. They were divided randomly into three groups and assigned different treatments. One group took 4,000 milligrams (mg) per day of acetaminophen divided into three doses. Another group was told to take up to 4,000 mg as needed for pain. The third group took a placebo pill.

No matter which regimen people were assigned, their back pain subsided in about 17 days. Researchers also looked for differences between the groups in pain intensity, physical disability, changes in symptoms, overall functioning, sleep quality, and general quality of life, but found no effect.