Pain Archive

When the minimally invasive procedure is warranted.

Arthroscopy is a popular technique for shoulder surgery because it involves a small incision. While it used to be the case that surgeons could see the shoulder tissues better with traditional open (large-incision) surgery, that has changed. "Our techniques have advanced to the point where sometimes we can see what's happening better with the scope than with open surgery," says Dr. Eric Berkson, director of the Sports Performance Center at Harvard-affiliated Massachusetts General Hospital. But when your surgeon will use arthroscopy depends on the particular condition that requires surgery.

The surgery

With arthroscopy, the surgeon makes a small incision and inserts long, thin surgical instruments—including one with a video camera that provides the inside view. "Because you can see better with arthroscopy, you can accomplish a repair without risking damage to the nearby deltoid muscle," says Dr. Berkson. "That cuts down on complications."

Research finds that acupuncture is an effective pain reliever.

When you're hurting, you might not necessarily think of getting relief from a needle stick—let alone several needle sticks. Yet research is finding that acupuncture—the traditional Chinese medicine practice of placing needles into the skin at strategic points throughout the body—is an effective way to ease some types of chronic pain.

Harvard researchers develop a tool to improve decision-making.

Treatment for a herniated disc—the rupture of one of the cushions between the bones of your spine—can range from physical therapy to pain-relieving injections to surgery. But when you and your physician decide on a treatment plan, are you well informed about its possible effect on your quality of life down the road? "It's a big problem if patients don't know what the disease is and what their options are. Research shows that if we did a better job of informing and engaging patients, there would likely be fewer major surgeries," says Dr. Karen Sepucha, assistant professor of medicine at Harvard Medical School.

To speed your recovery and return to daily activities as soon as possible, start your rehab before surgery.

This year, an estimated 600,000 people, 35% of whom are men, will receive a new knee. And why not? By replacing a joint ravaged by osteoarthritis—the leading reason people have implants—you can return to a level of physical functioning and freedom that you have not enjoyed for years.

Injections of corticosteroids can temporarily relieve the pain of a herniated disk, but offer little long-term benefit, finds a study in the Annals of Internal Medicine.

When a spinal disk bulges outward, or herniates, it may compress the nerves that branch outward to the rest of the body. This can cause shooting pain in the leg, known as sciatica. A common treatment for acute sciatica is injecting a corticosteroid drug near the bulging disk. This calms the inflammation and pain.

Q. I have pain in the ball of my foot, which my doctor thinks is caused by a Morton's neuroma. How did I get this and what can I do about it?

A. Morton's neuroma is a thickening of nerve tissue between the bones at the base of the toes (in the ball of the foot). It is caused by chronic injury or compression of the nerve tissue and can cause aching pain, a burning sensation, pins and needles, and numbness of the toes. A neuroma usually occurs between the bones of the third and fourth toes and occasionally between the second and third toes.

Inside your wrist, a slick tunnel passes through the carpal bones. The nerves and tendons of the wrist pass through this space, called the carpal tunnel. One of these nerves, the median nerve, controls sensations in the palm side of the thumb, the index and middle fingers, and half of the ring finger. It also transmits the impulses to certain hand muscles that allow the fingers and thumb to move. Carpal tunnel syndrome occurs when this nerve becomes irritated or squeezed. Symptoms include numbness, tingling, pain, or weakness in the hand of the affected wrist.

Because the carpal tunnel starts out narrow, it doesn't take much to aggravate or compress the median nerve. A number of conditions can make a person more prone to carpal tunnel syndrome. These include:

Your hands perform countless small and large tasks each day—from pouring coffee, brushing teeth, and buttoning shirts to raking leaves or kneading bread.

But aching hands can transform the simplest task into a painful ordeal. Hands can hurt for a variety of reasons, from the mechanical to the neurological. Arthritis—which affects one in five American adults—and other persistent joint problems are by far the most common cause of hand pain and disability.

Anti-inflammatory medications applied to the skin as creams, gels, sprays, or patches work best for mild to moderate pain near the surface.

Do you have mild to moderate osteoarthritis, or perhaps a sore shoulder or throbbing elbow from yard work? If the source of the pain is close to the surface, you should know about topical analgesics.

People with heart disease should avoid prolonged use of certain anti-inflammatory drugs. Naproxen (Aleve) is safest.

The "stomach friendly" prescription pain relievers Vioxx (rofecoxib) and Bextra (valdecoxib) were removed from the market when evidence emerged that they raised the risk of heart attacks. But Vioxx and Bextra left behind a couple of over-the-counter cousins: ibuprofen (Advil, Motrin) and naproxen (Aleve). The ways these drugs work are quite different, but they are all members of the
family called nonsteroidal anti-inflammatory drugs (NSAIDs).