Pain Archive

Key treatments for both diseases—exercise and medications—demand extra attention and planning

Many people with heart disease—nearly 60%—also deal with painful joint damage due to arthritis. Coping with both conditions together poses some special challenges, especially with regard to exercise and medications.

Staying active can strengthen bones and preserve mobility.

If your doctor has recently diagnosed you with osteoporosis, or if you've already had a fracture, you might be avoiding exercise for fear of breaking another bone. Yet staying active is exactly what you should be doing right now.

If you've already had one fracture, the risk of an additional fracture is very high, so you have to do everything possible to lessen the likelihood that will happen. You need to try to increase bone density and prevent falls, and that's where exercise is so important.

If you're overweight or obese, a combination of diet and exercise can help you lose more weight and reduce your knee pain better than either intervention alone. Being overweight can strain the knee joints, contributing to or worsening knee osteoarthritis. Researchers at Wake Forest University tested the effects of diet, exercise, or a combination of both on knee pain and function. They randomly assigned 454 overweight and obese adults (ages 55 and older) with knee osteoarthritis to one of three interventions—diet and exercise, diet only, or exercise only—and followed them for 18 months. People in the study who both dieted and exercised lost the most weight—11.4% of their body weight, compared with 9.5% for the diet group and 2% for the exercise group. They also had less knee pain, better function, and faster walking speed, according to the study, which was published in the Sept. 25, 2013, issue of The Journal of the American Medical Association.

A standard metal-and-plastic joint implant is a reliable, well-tested solution that could last a lifetime.

Total hip replacement has become routine. Any man healthy enough for the surgery can get a high-tech mechanical prosthesis to restore a painful, failing natural joint to its former function. More than 285,000 total hip replacements are performed each year in the United States, and new options have emerged to meet the demand. For example, you may have heard about hip resurfacing, a procedure in which damaged portions of the joint are sheathed in durable metal.

Think you shouldn't exercise because of your knee or hip osteoarthritis? You might want to think again, if the arthritis is mild to moderate. A new study finds that your best bet for pain relief may be strengthening and flexibility exercises. In an analysis of 60 randomized trails, published Sept. 20, 2013, in BMJ, researchers concluded that strengthening and flexibility exercises, done on land and in water, significantly reduced pain and also improved physical function. It's no surprise to Dr. Don Reilly, assistant clinical professor of orthopedic surgery at Harvard Medical School. "When you do repetitive activities, even with minimal force, it pumps some of the joint lubricant called synovial fluid into the cartilage, which keeps the cartilage healthy. Also, when you move a joint you build up a synovial fluid layer between the two moving parts, which helps decrease the friction in the joint," explains Dr. Reilly. He also recommends weight loss, because it decreases the amount of force placed on the joints. He cautions, however, that people with severe arthritis do only gentle exercise to increase the range of motion, as anything more strenuous will make pain worse.

What the location and severity reveals about your health.

If you're concerned about your heart, a sharp twinge in your chest may give you pause. If it's fleeting, it's probably nothing to worry about. But is that uncomfortable ache under your breastbone just heartburn—or a heart attack? It's often hard to tell. Understanding the underlying causes, symptoms, and duration of these two conditions—and others that cause similar sensations elsewhere in the body—can help you deal with the pain calmly and safely.

The pain reliever acetaminophen is safe when used correctly, but people can become very ill or die if they take too much.

Research finds little, if any, benefit to these shoe inserts.

Nearly a third of us will develop osteoarthritis of the knee by our 60s. With no cure for this painful joint condition on the horizon, relief often has to come from pain pills, exercises, and physical therapy—or eventually, a joint replacement.

You'll get relief faster by learning the symptoms of tension, migraine, and sinus headaches, as well as a stroke.

Different types of headaches respond to different treatments. So it's a good strategy to learn to identify the type of pain you're experiencing. "Knowing which type of headache you're dealing with will indicate which medications to use first. You'll know what to do about it, and you'll know what you're in for," says headache expert Dr. Paul Rizzoli, assistant professor of neurology at Harvard Medical School.

Q. Which is best for pain and stiffness from a sore back—heat or cold?

A. When choosing between heat and cold, you may be a better judge than your doctor. Nerve fibers that carry pain sensation also sense change in temperature. As a result, stimulating the nerves with either heat or cold can diminish your discomfort, so you can choose which one to try. Both may ease your pain.