Pain Archive

Today's high-tech procedure offers more benefits.

Here's another reason to get that knee replacement you've been debating: A new study presented at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons finds that adults with osteoarthritis face lower odds of developing heart failure by having a total knee replacement. The study did not show a direct cause and effect or prove definitively that a total knee replacement (TKR) could improve cardiovascular health. However, the procedure does allow the recipient to exercise again, which can lead to better heart health.

And that's just one of the benefits of today's TKR.

Contact lenses with vitamin E deliver long-lasting anesthetic.

Lasers have revolutionized the world of eye surgery. Unfortunately, the recovery afterward remains an uncomfortable experience that requires eye drops and sometimes prescription pain medications. The eye drops must be placed in the eye every few hours, and the pain medications come with the risk of overmedication and addiction.

Metal-on-metal hip replacements don't increase cancer

Physical conditioning and good playing technique and equipment can prevent golf elbow, tennis elbow, and similar overuse injuries.

What racquet sports player or golfer hasn't gotten sidelined—sometimes for months on end—by elbow pain? Occurring on either the inside or outside of the elbow, the pain can be intense and persistent; recovering from it calls for physical therapy and retraining.

Q. I wake up at night with pins and needles in one or both of my hands. I've tried chiropractic treatments, physical therapy, and a special pillow, with no success. What's causing this, and what can I do to stop it?

A. The likeliest cause of your symptoms is compression of one or both of the main nerves that supply feeling and function to your hands. These nerves—the median and ulnar nerves—run from the spinal cord at the neck all the way down to the hands. If they come under pressure at any point along the way, the arm or hand may feel as if it has "fallen asleep."

Dyspareunia is a common problem for many postmenopausal women.

Millions of women experience pain before, during, or after sexual intercourse—a condition called dyspareunia (from the Greek dyspareunos, meaning "badly mated"). This condition not only saps sexual desire and enjoyment, it can also strain relationships and erode quality of life in general. For postmenopausal women, dyspareunia may also raise concerns about aging and body image.

Many women suffer in silence and don't seek the help they need, or they have trouble finding a clinician who can diagnose and treat the causes of their pain. That is unfortunate, because treatments are available for many of the problems that underlie this vexing condition.

There are many treatments short of surgical replacement.

If your knees have become painful, tender, or swollen, are stiff first thing in the morning, or are making crackling noises, the probable cause is osteoarthritis, which affects more than two-thirds of women over age 60. Osteoarthritis results from the breakdown of joint cartilage, the tough, slippery tissue that protects the ends of bones (see "Anatomy of knee osteoarthritis"). Eventually, the cartilage may wear away completely, permitting bone to rub painfully against bone. The goals of osteoarthritis treatment are to reduce pain and stiffness, limit the progression of joint damage, and maintain and improve knee function and mobility.

About 5% of women in the United States over age 50 have had total knee replacement surgery, the recommended treatment when more conservative measures have failed and pain and disability are intolerable. The number of these procedures has more than doubled over the past decade, according to research presented at the 2012 annual meeting of the American Academy of Orthopaedic Surgeons (AAOS). This is partly because knee replacement works—more than 80% of patients say they're satisfied with the results. But experts say it's also a sign that people aren't fully utilizing the many noninvasive strategies that evidence suggests should be tried first—above all, weight loss and exercise.

Q. I'm in my late 70s and have been getting about four cortisone shots a year for the past several years for the arthritis in my left knee. They really help with the pain, but I've heard that, long-term, there could be bad side effects. Should I be worried?

A. Cortisone is one of the many corticosteroid drugs. The corticosteroids are powerful anti-inflammatories that can do a lot to relieve pain, but the side effects are a drawback. As pills, they deplete bone and have other systemic effects. Injected cortisone, which is often combined with lidocaine, a short-acting pain reliever, sometimes clumps into crystals and may worsen pain rather than relieve it. Repeated shots can eventually damage skin and other tissues. Small amounts of cortisone that have been injected into a joint can get into the rest of the body and have hormone-like effects that make diabetes harder to control. There's also the slight risk of the shots leading to an infection of the joint.

Low back pain has many different causes, including the normal wear and tear that comes with aging. While you can't turn back the clock or prevent every type of painful back disorder, in most cases there are things you can do to help keep your back healthy.

1. Stay fit

Weak back and abdominal muscles — due to deconditioning or age — cause or exacerbate many cases of low back pain. That's why stretching and strengthening both your back and abdominal muscles is important not only for treating low back pain, but also for helping to prevent a recurrence of the problem.

Regular bunions affect the big toe; a tailor's bunion, the little toe. Another term for tailor's bunion is bunionette.

Both types are caused by a misalignment of the small bones in the toes. As a result, the joint between the metatarsal and the first phalanx juts out and the end of the toe turns inward, toward the middle three toes.