Pain Archive

Ask the doctor

Image: Karl Rosencrants/ Thinkstock

Q. It's been suggested that drinking 2 to 3 ounces of tonic water before bedtime can prevent leg cramps at night. Is that true?

A. Tonic water—and the quinine it contains—have been promoted for preventing leg cramps for decades despite the lack of evidence that they are effective. Quinine is FDA-approved only for treating malaria and is sold with a warning against using it to treat leg cramps or muscle pain, because it increases the risk of bleeding and heart rhythm disturbances. Tonic water contains no more than 83 mg of quinine per liter—a much lower concentration than the 500 to 1,000 mg in the therapeutic dose of quinine tablets. Drinking a few ounces of tonic water shouldn't be harmful, but it isn't likely to prevent your leg cramps.

The negative emotions that come from coping with chronic pain can lead to depression, and that very depression can lead to worse pain. Understanding the connection between pain and emotional health with the help of a psychologist can address these issues, and there are evidence-based therapies that can help as well.

There are several things you can do to prevent or minimize the aches and pains that might accompany statin use.

If you're not taking a statin now, you may well be soon. These medications are commonly prescribed to lower "bad" LDL cholesterol and have been shown to reduce the risk of heart attack, stroke, and death. They are routinely recommended for people who have cardiovascular disease and for many people ages 40 to 75 who don't have cardiovascular disease but have at least one risk factor (high blood pressure, high cholesterol, diabetes, or smoking) and a 7.5% or greater risk of a stroke or heart attack in the next decade. Moreover, recent research indicates that they may benefit high risk individuals over age 75 as well.

Muscle pain and other statin side effects

Taking a statin may give you some assurance that you're doing all you can to avoid heart attack and stroke, but you may also experience side effects. Reported side effects include an increased chance of developing diabetes — which is largely restricted to people who are already at risk for diabetes, and who can be monitored with glucose or hemoglobin A1c tests. Statin use has also been associated with difficulties with memory and reasoning, although there is no clear evidence that the drugs were responsible. In very rare cases, statins may cause liver problems or a potentially life-threatening breakdown in muscle cells.

Keeping your shoulder muscles flexible will help prevent injury.

The shoulder is the body's most complicated joint. It's where the ends of the collarbone, upper arm bone, and shoulder blade meet. And it's prone to arthritis (a wearing away of the cartilage between the bones), as well as tears or tendinitis (inflammation) in the rotator cuff — the group of tendons that helps you raise and rotate your arm. Shoulder pain can keep you from being able to raise your arms to get dressed, or reach up to a cupboard or out to a door.

But an easy way to stave off shoulder problems is to regularly stretch the muscles that support the joints. "The muscles need to be long and flexible to stay healthy. You're more vulnerable to injury when your shoulder muscles are tight and restricted," explains Clare Safran-Norton, clinical supervisor of rehabilitation services at Harvard-affiliated Brigham and Women's Hospital.

In the journals

Previous studies have shown a link between loss of smell among older adults and risk of death within a short period — often five years or less. Now, a report published online May 21, 2019, by Annals of Internal Medicine confirmed this increased risk of death over more than a decade, as well as identifying the leading causes of death.

Researchers gave smell identification tests to 2,289 adults ages 71 to 82 (about half of whom were men). They found that those who scored low on the smell test had a 46% higher risk of dying within 10 years, and 30% within 13 years, compared with those who had a stronger sense of smell.

Ask the doctors

Q. My mother has fibromyalgia, and I think I'm starting to experience similar symptoms. Is fibromyalgia hereditary?

A. Yes. Fibromyalgia, a chronic pain condition that affects some six million or more Americans, can run in families. In fact, one of the most important risk factors for fibromyalgia is a family history of the disorder. Fibromyalgia is sometimes known to affect multiple members of the same family. Your risk rises if you have a first-degree relative — a parent, a brother, sister, or child — with the condition.

Ask the doctors

Q. I have arthritis and my doctor recommended I start exercising, but I'm worried it will make my pain worse. Should I follow her advice?

A. Yes, your doctor is right. Although it may seem counterintuitive to move more when your joints hurt, studies have shown that exercise can reduce arthritis-related pain, fatigue, and stiffness. Exercise is also important for your overall health and can help reduce your risk of heart disease, obesity, and diabetes.

Treating underlying conditions and using helpful strategies may be all it takes to get you back on track.

Reading for pleasure is one of life's great gifts. It's an escape to another world or a path to increased knowledge. Plus, reading about a subject that's new to you challenges the brain, which may help create new brain cell connections. But many aspects of health can affect our ability to read in older age.

Physical changes

Chronic disease and age-related changes can have a big effect on your ability to read. Consider these factors:

Ask the doctor

Q. My brother went to the emergency room because he thought he was having a heart attack. Instead, he was diagnosed with costochondritis. What is that?

A. Costochondritis is caused by inflammation of the cartilage between the ribs and the breastbone, called the costosternal joints (see illustration). This uncommon condition can trigger a stabbing, aching pain that's often mistaken for a heart attack.