Pain Archive

The stigma is fading, but learn the pros and cons before trying it.

Despite the hype and popularity of medical marijuana, you may not be sure if it's something to consider. You're right to be cautious; the use of marijuana to treat health problems is still being studied, and we don't have all the answers about its risks and benefits.

We do know that medical marijuana use among older adults is increasing. "Older adults tend to use it for physical ailments. No. 1 is chronic pain. Insomnia is another big one, too. Older people have a hard time sleeping, and there aren't a lot of other safe options," says Dr. Peter Grinspoon, a primary care physician with Harvard-affiliated Massachusetts General Hospital.

Some common painkillers may boost the odds of a heart problem. Use them wisely to lessen your risk.

In 2004, the drug maker Merck pulled rofecoxib (Vioxx) off the market, following revelations that the popular prescription painkiller increased the risk of heart attacks and strokes. That action triggered a closer look at drugs in the same class, known as nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs, which are widely used to ease pain, quell inflammation, and cool fevers, include over-the-counter drugs such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn) and the prescription drug celecoxib (Celebrex).

A high pain tolerance may account for some "silent" heart attacks. But failing to recognize atypical symptoms is a more likely explanation.

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Nearly half of people who have a heart attack don't realize it at the time. These so-called silent heart attacks are only diagnosed after the event, when a recording of the heart's electrical activity (an electrocardiogram, or ECG) or another test reveals evidence of damage to the heart.

What's behind this surprising phenomenon? One explanation may be a higher-than-average tolerance for pain, as a recent study suggests (see "Does a high pain tolerance mask heart attack symptoms?"). Other people mistake their symptoms as indigestion or muscle pain. Still others may feel pain, but in parts of their upper body other than the center of the chest.

Tennis elbow is the common term for lateral epicondylitis, an inflammatory condition of the tendon that connects the extensor muscles of the lower arm to a bony prominence on the outside of the elbow called the lateral epicondyle. The condition causes pain at the point where the tendon attaches to the epicondyle. The pain may radiate to the forearm and wrist, and in severe cases, grip strength may lessen. It can become difficult to perform simple actions like lifting a cup, turning a key, or shaking hands.

As many as half of all people who play racket sports have the condition, but most people who have tennis elbow didn't acquire it by playing tennis, squash, or racquetball. It can result from any activity that involves twisting or gripping motions in which the forearm muscles are repeatedly contracted against resistance, such as pruning bushes or pulling weeds, using a screwdriver, or playing a violin. Tennis elbow is an occupational hazard for professional gardeners, dentists, and carpenters.

Breast pain after menopause can come in many forms

Menopause has come and gone. Why do I still have breast pain?

In most cases, breast pain is a by-product of reproductive life: Like breast swelling, it waxes and wanes during the menstrual cycle, and it's one of the first symptoms of pregnancy. Many women expect breast pain to go away after menopause. When it doesn't, they may fear they have breast cancer. Fortunately, breast pain is rarely a symptom of cancer, regardless of age. Still, that possibility should be considered, along with a number of noncancerous conditions that affect the breasts.

The truth – and the myth – behind the cracking knuckles debate

Cracking your knuckles may aggravate the people around you, but it probably won't raise your risk for arthritis. That's the conclusion of several studies that compared rates of hand arthritis among habitual knuckle-crackers and people who didn't crack their knuckles.

The "pop" of a cracked knuckle is caused by bubbles bursting in the synovial fluid — the fluid that helps lubricate joints. The bubbles pop when you pull the bones apart, either by stretching the fingers or bending them backward, creating negative pressure. One study's authors compared the sudden, vibratory energy produced during knuckle cracking to "the forces responsible for the destruction of hydraulic blades and ship propellers."

Sometimes it's hard to tell the difference between a heart attack, heartburn, and lung problems.

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Many kinds of health problems can cause chest discomfort, with symptoms so intense that you rush to the hospital. "I see older adults with chest pain or something related to it every time I work in the emergency department," says Dr. Kei Ouchi, an emergency medicine physician at Harvard-affiliated Brigham and Women's Hospital.

The big fear

You may worry that chest pain is due to a heart attack, which occurs when blood flow to the heart is blocked, typically by a blood clot and narrowed arteries. Classic symptoms include pressure or squeezing in the chest, lightheadedness, and pain in the shoulder, arm, neck, jaw, or back.

Osteoarthritis pain can be debilitating. Strategies can help get you moving again.

Pain from osteoarthritis is more than just a nuisance. Knee pain, in particular, can not only keep people from exercising, but also have a chilling effect on their ability to participate in social activities, especially those that involve walking or traveling, says Elena Losina, the Robert W. Lovett Professor of Orthopedic Surgery at Harvard Medical School and co-director of the Orthopaedic and Arthritis Center for Outcomes Research at Brigham and Women's Hospital.

"In fact, the quality of life of a person with persistent pain due to knee osteoarthritis is similar to quality of life in women with metastatic breast cancer controlled by therapy," she says.

On call

Q. I occasionally get an excruciating leg cramp that wakes me from sleep. What causes leg cramps, and how can I prevent them?

A. Although nocturnal leg cramps can strike people at any time of life, they become more frequent with age. Among people older than age 50, about half report having leg cramps, a third say they are awakened at night by them, and 15% report having cramps about once per week.