Pain Archive

Spinal stenosis—narrowing of the spinal canal that increases pressure on spinal nerves—is a common source of lower back pain and weakness. Although many people assume that surgery to remove pressure on the nerves is the most effective way to bring relief, there is little evidence to support that assumption. A study reported in the April 7, 2015, issue of Annals of Internal Medicine indicates that physical therapy may be just as effective as back surgery in providing pain relief and enabling people to get around better.

For the study, 169 men and women with disabling spinal stenosis were randomly assigned to two groups—87 to have surgery and 82 to have intensive physical therapy. Two years later, both groups had similar results on physical function tests. However, 33 of the patients who underwent surgery had complications, usually requiring more surgery.

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

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.

Q. I'm a 78-year-old athlete and dancer. Three years ago, I broke my hip. After it was repaired I completed extensive physical therapy. Since then, I've been working out at a gym using the treadmill, stationary bicycle, and rowing machine. But I still have tremendous pain in my thigh. Should I stop exercising? It helps me control my weight and blood pressure.

A. I applaud you for persisting with your exercise. You're not only keeping your weight and blood pressure down but you're also building stronger bones to help prevent fractures in the future.

Relaxation, meditation, positive thinking, and other mind-body techniques can help reduce your need for pain medication.

Drugs are very good at getting rid of pain, but they often have unpleasant, and even serious, side effects when used for a long time. If you have backache, fibromyalgia, arthritis, or other chronic pain that interferes with your daily life, you may be looking for a way to relieve discomfort that doesn't involve drugs. Some age-old techniques—including meditation and yoga—as well as newer variations may help reduce your need for pain medication.

Q. Because I'm a former smoker and was having leg pains, my doctor recommended that I have an ankle-brachial index test. He said my score was on the low side. What does that mean?

A. The ankle-brachial index is a test that measures blood pressure at the brachial artery (in the arm, close to the heart) and the ankle (far from the heart). Normally, blood pressure in the legs is the same or a little higher than in the arm, so the ratio between the arm and ankle is 1.0 or higher. A lower ratio (less than 0.95) means blood is not moving well in the lower half of your body. You may have peripheral artery disease (PAD), which is usually caused by a buildup of fatty deposits in arteries in the legs that limits blood flow to the muscles. People with significant leg pain and cramping during exercise—the most common symptoms of PAD—usually have an ankle-brachial ratio of 0.8 or less.

Here are some steps you can take to reduce your reliance on medication to control symptoms and stay functional.

There's been a lot of research on what puts men at greater risk of back problems, like being overweight or sedentary. But we know less about what exactly triggers a bout of back pain. A new study in Arthritis Care and Research helps fill that gap.

The study involved 1,000 people who went to 300 different clinics in Australia with low back pain. The researchers carefully interviewed the participants to figure out when the back pain started and possible triggers they noticed within two hours of when the pain started.

It should be matched to the right pain condition and used for a limited time—then switch to safer options.

Over-the-counter pain relievers are great for ordinary aches and pains, but for severe, unrelenting pain that interferes with daily life, you may need something stronger. In such cases, men may end up taking medications called opioids, which block pain perception in the brain. The best-known opioid drugs are oxycodone (OxyContin, Percocet) and hydrocodone (Vicodin).

The pain from an arthritic knee can be intense, limiting daily activities and independence. Men can try a range of medications, but overall acetaminophen (Tylenol, other brands) appears to relieve pain only slightly better than a placebo pill, according to a research review in Annals of Internal Medicine.

The researchers pooled results from 137 randomized clinical trials involving about 33,000 people with knee arthritis and compared the relative effectiveness of the following treatments: