Pain Archive

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.

Older adults with new back pain usually end up getting a CT scan or MRI. That’s often a waste of time and money and has little or no effect on the outcome, according to a new study from the University of Washington. The results of the study contradict current guidelines from the American College of Radiology. The guidelines say that it’s “appropriate” for doctors to order early MRIs for people ages 70 and older with new-onset back pain, and many doctors do just that. The study, which followed more than 5,200 men and women over the age of 65 who saw a primary care physician for a new bout of back pain, found that people who got early back scans did no better than those who didn’t have scans. The scans added about $1,400 per person to the overall cost of back pain care — with no measurable benefit.

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:

The telltale sign is leg pain and fatigue that comes on with activity and goes away with rest.

Although these powerful pain relievers can be addictive, opioids are safe for most people when used properly.

Mobility relies on the body's two largest joints, the hips and knees. We ask a lot of both these joints: they must bear our full weight and coordinate movement over a lifetime of standing, walking, running, dancing, and sports. Not surprisingly, hip and knee pain are common complaints, and nearly everyone who lives into old age can expect some trouble with these joints. But taking care of your hips and knees and managing any pain that arises will help you avoid losing mobility as you age.

Try these self-help measures when knee or hip pain strikes:

It can reduce discomfort and get you back on your feet faster.