Pain Archive

Inpatient, outpatient, and at-home rehab all aim to restore your function and independence.

Have shoulder pain? Recovering from traumatic illness, surgery, or a bad fall? Your doctor may well recommend physical rehabilitation or physical therapy to get you back to your daily routine and the activities you love. There are several options available, depending on your needs.

1. Inpatient rehab

Inpatient rehab is prescribed after a hospital stay, when you're not well enough to go home. It offers comprehensive care from doctors, nurses, therapists, and other health professionals. There are two types of this rehab.

Men may avoid activity because of their knee pain, but movement is exactly what they need.

It is perhaps the ultimate exercise catch-22: it's hard to move with knee osteoarthritis, but moving helps relieve osteoarthritis knee pain.

More than 30 million Americans have osteoarthritis, the most common kind of arthritis. While osteoarthritis can affect the hips, lower back, neck, and fingers, it occurs most often in the knees. In fact, an estimated 10% of men ages 60 and older have symptoms of knee osteoarthritis.

Antidepressant medications are frequently prescribed for chronic pain, particularly neck or low back pain and certain types of arthritis — though other treatments are usually tried first. An analysis of past research considered how effective antidepressants are for these types of pain, but the results are not encouraging.

The ideal workout program for osteoporosis combines weight-bearing, muscle-strengthening, flexibility, and balance exercises.

Mindfulness can help soothe short-term and chronic pain.

Your mind is a powerful pain remedy when given the chance. Science continues to show how mindfulness can manage pain — and it doesn't take years to master.

"Using mindfulness is a way for older adults to treat ongoing chronic pain and the occasional flare-up without having to always rely on medication," says Ellen Slawsby, director of pain services at Harvard-affiliated Benson-Henry Institute for Mind Body Medicine.

Research we're watching

There are a number of different approaches to treating a condition called adhesive capsulitis, better known as frozen shoulder. This common condition causes significant shoulder pain and reduced mobility. While it generally goes away on its own over time, it can take up to a year or longer to heal. But there hasn't been consensus on whether any particular therapy leads to more rapid pain relief and full range of motion.

A study published online Dec. 16, 2020, by JAMA Network Open looked at various treatment options for frozen shoulder to determine which was the most effective. Researchers analyzed 65 different studies with more than 4,000 total participants and found that the first line of therapy should be to inject a steroid directly into the joint to reduce inflammation. This treatment helped to reduce pain and led to the fastest recovery. The study authors said the steroid injection should be accompanied by a home exercise program that includes stretches and exercises to improve range of movement in the shoulder.

Exercise and recreational balls can play an important role in recovery and pain reduction.

A golf ball to ease foot pain? A kids' playground ball to recover from a knee injury? The combinations may sound foreign, but they're familiar approaches in the world of physical therapy. Here's how these tools of the trade (and the toy box) can help you.

A playground ball

This is the kind of inexpensive rubber or plastic ball (less than $10) you'll find at a grocery or big-box store. It's about the size of a soccer ball, but lighter. "We commonly use that type of ball for knee rehabilitation. We'll have someone do mini squats against the wall with the ball between the knees. Squeezing the ball strengthens the quadriceps muscles," explains Clare Safran-Norton, clinical supervisor of rehabilitation ­services at Harvard-affiliated Brigham and Women's Hospital.

It's more accessible than ever before, but is it the right medicine for you?

Medical marijuana — also referred to as medical cannabis — has enjoyed a boom in recent years. More states have legalized it, more products are available, and more people have turned to it for help, especially older adults.

A study in the April 2020 JAMA Internal Medicine found that the number of adults ages 65 and older using medical cannabis increased from 2.4% to 4.2% between 2015 and 2018.

A novel study suggests that the "nocebo effect" could be why some people believe they cannot tolerate statins.

Are you hesitant to fill your statin prescription because you're worried the drug will cause muscle aches and other side effects? Although you're far from alone (see "A royal pain?"), the reality is that all drugs have side effects, and statins aren't worse than other drugs. And fears about statin side effects may be depriving people of a potentially lifesaving medication.

The nocebo effect — the flip side of the well-known placebo effect — occurs when people experience negative effects from a drug, placebo, or other treatment based on an expectation of harm. Because of the widespread belief that statins cause muscle aches, statins have been suspected of triggering a strong nocebo effect. A recent study confirmed this observation (see "A study to assess statin side effects").

Ask the doctors

Q. I eat a lot of shellfish and recently developed gout in my knee. Did my diet cause the condition?

A. As you probably know, gout is a painful form of arthritis that occurs when high levels of a waste product called uric acid build up in the body. It can settle into joints, where it forms sharp crystals that can trigger inflammation, redness, and pain. Your diet may have aggravated the condition, but didn't cause it.