Pain Archive

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Does double knee surgery make sense for you?

The idea of having a knee replaced is daunting. But what if both of your knees need repairing? Is one visit to the operating room better than two?

If you are otherwise in good health, it's a conversation worth having with your doctor and rehabilitation team. There are some benefits to replacing both joints during a single surgery (called simultaneous replacement). These include undergoing anesthesia only once, fewer days in the hospital, and only one (albeit prolonged) rehabilitation that lets you resume normal activities sooner than two separate ones. 

Foot problems? Try these tips to find comfortable shoes

Look for roomy toe boxes, soft inner soles, and sturdy heel counters to give you a better fit and help you stay on the go.


Image: Thinkstock

Bunions, hammertoes, corns, and calluses all make shoe buying a chore. But the wrong shoes can impair your mobility and independence. "Pain from any of those conditions can alter your gait," says Dr. James Ioli, assistant professor of orthopedic surgery at Harvard Medical School.

Corns and calluses

Bunions and hammertoes

A bunion develops at the base of your big toe when two bones no longer connect properly, causing the base to jut out-ward. Some people are genetically vulnerable to getting bunions. However, bunions are more likely to develop in people (often women) wearing shoes that crowd the toes.

Hammertoes are deformed, bent toes that may result from poorly fitting shoes, a ligament problem, or a bunion that pushes one toe over another.

If bunions and hammertoes don't bother you, there's no need to treat them. "I have many patients who are runners with hammertoes and bunions who successfully compete without any trouble. It's all a matter of individual mechanical issues," says Dr. Ioli. If the deformities bother you, surgery to realign the bones is possible, but that is a last resort.

Shoe hunt

Other options

Even a roomy toe box may cause a little friction when you walk. That's when using moleskin pads on your toes or feet can help. These soft pads have an adhesive backing that you attach to an affected foot or toe area, or to the inside of your shoe. It protects against friction. You can find moleskin pads in drugstores. Toe separators can help relieve pain from corns be-tween the toes.

Some shoes are designed specifically to relieve pressure on bunions. You can find them in specialty shoe stores. But prepare to pay more for these kinds of shoes. They typically run $100 to $200 per pair. Are they worth it? "If they relieve pressure points and decrease pain on the bunion or hammertoes or any deformity, that's good," says Dr. Ioli, "but you can find comfortable shoes for less if you do a little detective work."

Figure 1: Finding a comfortable fit for ailing feet

When shopping for comfy shoes, look for these important features.

 

Muscle problems caused by statins: Can a genetic test reveal your risk?

A mail-order saliva test marketed to consumers may make some promises it can't deliver.

A new mail-order genetic test called StatinSmart bills itself as the first test to identify a person's risk of experiencing muscle pain from a statin. That sounds like potentially helpful information, given that up to half of people who are prescribed statins quit taking them because of perceived side effects—most often muscle pain. Others avoid statins altogether because of that worry.

But here's the rub: muscle problems can range from mild to serious, and the terms experts use to describe them can be confusing. The StatinSmart website says 29% of people who take a statin develop "statin-induced myopathy," which they define as muscle aches, pains, weakness, or cramps.

Prescription pain pills: Worth the risks?

Thorough risk assessment and family assistance may help you take them more safely.

Prescription pain pills such as oxycodone (Oxycontin) and hydrocodone (Vicodin) are in a class of drugs known as opioids. They're typically used to treat severe pain after surgery, and sometimes to treat chronic pain. But these drugs come with many risks, including addiction. Does that put you at risk if you take opioids? "You have to look at it on a case-by-case basis," says Dr. Hilary Connery, an addiction psychiatrist at Harvard-affiliated McLean Hospital.

Risks and benefits

Opioids are powerful painkillers that block messages of pain to the brain and decrease the body's perception of discomfort. They may also create a feeling of euphoria. Opioids are especially useful in the short term, such as the initial weeks following joint replacement. Common side effects include nausea, itching, drowsiness, or constipation.

Sciatica: Of all the nerve

Sciatica does not need to be a pain to treat. There are several ways to minimize and manage flare-ups.

Sciatica is one of the most common, yet misunderstood, types of pain. As many as 40% of people will get it during their life, and it becomes more frequent as you age.

"People who suffer from acute or chronic back pain tend to be more susceptible to sciatica," says Dr. Jeffrey N. Katz, professor of medicine and orthopedic surgery at Harvard Medical School. "Your risk also rises if you're obese, if you smoke, or if you're sedentary."

Acupuncture and Alexander Technique help relieve chronic neck pain

Troubled by long-term neck pain? Acupuncture and the Alexander Technique may offer relief, says a study in the Nov. 3, 2015, issue of the Annals of Internal Medicine.

British researchers recruited 517 patients who suffered from neck pain for an average of six years. They were randomly placed in three groups: one got up to 20 half-hour Alexander Technique lessons, the second had up to a dozen 50-minute sessions of acupuncture, and the third group received standard treatments, such as medications and physical therapy.

How music can help you heal

Music therapy can calm anxiety, ease pain, and provide a pleasant diversion during chemotherapy or a hospital stay.

It's almost impossible to find someone who doesn't feel a strong connection to music. Even if you can't carry a tune or play an instrument, you can probably reel off a list of songs that evoke happy memories and raise your spirits. Surgeons have long played their favorite music to relieve stress in the operating room, and extending music to patients has been linked to improved surgical outcomes. In the past few decades, music therapy has played an increasing role in all facets of healing.

What is music therapy?

Music therapy is a burgeoning field. People who become certified music therapists are usually accomplished musicians who have deep knowledge of how music can evoke emotional responses to relax or stimulate people or help them heal. They combine this knowledge with their familiarity with a wide variety of musical styles to find the specific kind that can get you through a challenging physical rehab session or guide you into meditation. And they can find that music in your favorite genre, be it electropop or grand opera.

Is it time to give acupuncture a try for pain relief?


Image: Bigstock

For many conditions, this "alternative" treatment may be just as effective as—and may cause fewer side effects than—pain medication.

If you have chronic pain and are wondering how to avoid the potential side effects associated with long-term use of pain medications, you may want to consider an alternative—acupuncture. Since the technique was introduced in the United States in the 1970s, it has moved from alternative to mainstream medicine. Today, Harvard Medical School and other leading institutions offer courses in acupuncture for physicians, several professional societies certify acupuncturists, and two to three million Americans visit an acupuncturist every year.

Fight back against gout

This common inflammation of the joints can be treated and managed with medication and lifestyle changes.

Gout affects more than eight million adults, six million of whom are men. It often strikes suddenly, like flicking on a light switch, and the pain is severe, with intense swelling and redness.

Food choices can dictate if you get gout, as high intake of organ meat, shellfish, and alcohol can raise your risk. But diet is only a part of it. "There is a direct relationship between advancing age and gout," says Dr. Robert Shmerling, clinical chief of rheumatology at Beth Israel Deaconess Medical Center.

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