September 29, 2009
www.nytimes.com
Roni Caryn Rabin
Some women love their shoes so much it hurts.
That is the conclusion of a new study that looks at the link between shoes and foot pain. It was based on questioning of 3,378 men and women from Framingham, Mass., about their shoes in the past and the present. Their average age was 66.
The researchers found that women who had mainly worn supportive footwear like sneakers or athletic shoes in their early years cut their risk of foot pain later by more than half, compared with women who had worn shoes that gave average support, like hard-soled or rubber-soled ones.
But both of those groups were in a minority. More than 60 percent said that in the past they generally wore high heels, pumps, sandals and slippers, all of which researchers rated as higher risk. Women who wore those were at the most risk of hindfoot, ankle and Achilles’ tendon pain. More...
PainCareMD
Thursday, October 22, 2009
Aging Well: Medications Blurring the Line Between Helpful, Harmful
September 28, 2009
www.craigdailypress.com
Tamera Manzanares
Chronic pain, anxiety and depression are just a few problems that can send a person to their doctor’s office for relief. Chances are, they will leave with one or more prescriptions for medications.
Although prescription drugs and over-the-counter medications can greatly improve a person’s quality of life, misuse can quickly blur the line between feeling better and feeling worse.
Older adults consume the most prescription and over-the-counter drugs of any age group. This, in addition to other age-related changes, make older adults particularly vulnerable to substance abuse problems, according to “Substance Abuse and Mental Health Among Older Americans,” a 2005 report by the Substance Abuse and Mental Health Services Administration.
Despite this, a growing body of research suggests misuse and other medication-related problems in older adults can be avoided.
Focusing more research and screening on potential effects of certain drugs on older individuals and spreading awareness of these issues among the medical community, patients and caregivers are among recommendations from an expert panel assembled by the nonprofit Alliance for Aging Research. More...
PainCareMD
www.craigdailypress.com
Tamera Manzanares
Chronic pain, anxiety and depression are just a few problems that can send a person to their doctor’s office for relief. Chances are, they will leave with one or more prescriptions for medications.
Although prescription drugs and over-the-counter medications can greatly improve a person’s quality of life, misuse can quickly blur the line between feeling better and feeling worse.
Older adults consume the most prescription and over-the-counter drugs of any age group. This, in addition to other age-related changes, make older adults particularly vulnerable to substance abuse problems, according to “Substance Abuse and Mental Health Among Older Americans,” a 2005 report by the Substance Abuse and Mental Health Services Administration.
Despite this, a growing body of research suggests misuse and other medication-related problems in older adults can be avoided.
Focusing more research and screening on potential effects of certain drugs on older individuals and spreading awareness of these issues among the medical community, patients and caregivers are among recommendations from an expert panel assembled by the nonprofit Alliance for Aging Research. More...
PainCareMD
Tuesday, October 20, 2009
Persistent Pain May Speed Signs of Aging, Study Reveals
September 29, 2009
Medill Reports Chicago
Renee Park
Clarise Hildreth, 88, has pain in the knees, stiffness and wears a pain patch. The resident of the Johnston R. Bowman Health Center in Chicago's West Side, was diagnosed with a severe arthritic condition affecting her spine.
But while she suffers from pain, she still enjoys participating in daily activities, including shopping and going out to lunch with friends.
“You can adjust your life to the pain. If you work out and take the medicines and treatments that are necessary, then you can do it. It’s [in] the mindset,” she said. She said she started feeling persistent back pain several years ago. Hildreth is among the lucky ones because she gets pain relief.
It’s common knowledge that as you get older, daily tasks such as carrying your groceries, can get harder. A new Northwestern University and University of California, San Francisco study, published in the September issue of the Journal of the American Geriatrics Society, found constant pain interferes with people's ability to accomplish basic tasks. They found that pain may accelerate some signs normally associated with aging.
“The rate at which people develop disabilities associated with aging happens at markedly different rates,” said Dr. Kenneth Covinsky, the lead researcher of the study and staff physician at the San Francisco VA Medical Center. Pain may help explain why some people experience functional limitations in mobility, or a decline in the ability to do simple tasks, faster than others, he said.
Researchers analyzed data from over 18,000 Americans involved in the University of Michigan Health and Retirement Study (HRS). Started in 1992 and sponsored by the National Institute on Aging, the Health and Retirement Study is an ongoing longitudinal study that focuses on Americans aged 50 and over.
Participants were asked to rate their ability levels across four measures: mobility, stair climbing, upper extremity tasks, including the ability to lift their arms over their heads, and activity of daily living, such as dressing and eating. Beforehand, subjects were asked if they experienced pain on a regular basis. Subjects with pain then rated their pain levels from mild to severe.
Subjects in their fifties with persistent pain were similar to subjects in their eighties without continuous pain. For example, while more than 90 percent of subjects in their fifties without pain were able to walk several blocks, only 50 percent of pain ridden subjects in their fifties reported walking several blocks with ease. More...
PainCareMD
Medill Reports Chicago
Renee Park
Clarise Hildreth, 88, has pain in the knees, stiffness and wears a pain patch. The resident of the Johnston R. Bowman Health Center in Chicago's West Side, was diagnosed with a severe arthritic condition affecting her spine.
But while she suffers from pain, she still enjoys participating in daily activities, including shopping and going out to lunch with friends.
“You can adjust your life to the pain. If you work out and take the medicines and treatments that are necessary, then you can do it. It’s [in] the mindset,” she said. She said she started feeling persistent back pain several years ago. Hildreth is among the lucky ones because she gets pain relief.
It’s common knowledge that as you get older, daily tasks such as carrying your groceries, can get harder. A new Northwestern University and University of California, San Francisco study, published in the September issue of the Journal of the American Geriatrics Society, found constant pain interferes with people's ability to accomplish basic tasks. They found that pain may accelerate some signs normally associated with aging.
“The rate at which people develop disabilities associated with aging happens at markedly different rates,” said Dr. Kenneth Covinsky, the lead researcher of the study and staff physician at the San Francisco VA Medical Center. Pain may help explain why some people experience functional limitations in mobility, or a decline in the ability to do simple tasks, faster than others, he said.
Researchers analyzed data from over 18,000 Americans involved in the University of Michigan Health and Retirement Study (HRS). Started in 1992 and sponsored by the National Institute on Aging, the Health and Retirement Study is an ongoing longitudinal study that focuses on Americans aged 50 and over.
Participants were asked to rate their ability levels across four measures: mobility, stair climbing, upper extremity tasks, including the ability to lift their arms over their heads, and activity of daily living, such as dressing and eating. Beforehand, subjects were asked if they experienced pain on a regular basis. Subjects with pain then rated their pain levels from mild to severe.
Subjects in their fifties with persistent pain were similar to subjects in their eighties without continuous pain. For example, while more than 90 percent of subjects in their fifties without pain were able to walk several blocks, only 50 percent of pain ridden subjects in their fifties reported walking several blocks with ease. More...
PainCareMD
A Relief? Lower Back Pain Unlikely to Mean Cancer
September 30, 2009
www.abcnews.com
Megan Brooks
Your lower back pain may be killing you, but there's some good news: Such pain is very unlikely to mean serious problems such as broken vertebrae or cancer, according to a study by Australian researchers.
Dr. Christopher G. Maher, from The George Institute of International Health in Sydney, and colleagues studied 1172 patients who came to general practitioners, physical therapists, or chiropractors with a new complaint of lower back pain.
The patients were monitored for 12 months to look for broken bones, infection, arthritis, or cancer was the cause.
"Many people worry that their back pain may be an indicator of something more serious," Maher noted in an email to Reuters Health. But among all 1,172 patients, only 11 cases were anything serious at all, and eight of those 11 were broken vertebrae. More...
PainCareMD
www.abcnews.com
Megan Brooks
Your lower back pain may be killing you, but there's some good news: Such pain is very unlikely to mean serious problems such as broken vertebrae or cancer, according to a study by Australian researchers.
Dr. Christopher G. Maher, from The George Institute of International Health in Sydney, and colleagues studied 1172 patients who came to general practitioners, physical therapists, or chiropractors with a new complaint of lower back pain.
The patients were monitored for 12 months to look for broken bones, infection, arthritis, or cancer was the cause.
"Many people worry that their back pain may be an indicator of something more serious," Maher noted in an email to Reuters Health. But among all 1,172 patients, only 11 cases were anything serious at all, and eight of those 11 were broken vertebrae. More...
PainCareMD
Special K is Tough on Pain
September 28, 2009
www.miller-mccune.com
Janice Arenofsky
Ketamine has captivated physicians and teens ever since 1970 when the FDA approved the drug as a surgical anesthesia, and young adults started getting high on it. First marketed as a veterinary anesthetic, ketamine — which is chemically related to PCP and encourages psychological and physical dependence — quickly caught on with drug abusers. By 1981 the U.S. Department of Health and Human Services recommended ketamine's reclassification as a controlled substance, but the DEA rejected the idea until 1992 when it received 775 reports of ketamine abuse, including veterinary clinic burglaries and hospital emergency room visits.
Despite an association with date rape and other hallucinatory drugs, infusions of ketamine now represent last-resort therapy for those with the intractable disease known as complex regional pain syndrome. The only drawback to treatment is patients literally may be betting their lives against this unorthodox, and potentially excessive, use of the drug.
"It's a crappy disease," said Philip Getson, clinical associate professor of neurology at Drexel University College of Medicine in Philadelphia. The syndrome ranks No. 1 in painful chronic conditions, according to the McGill Pain Index, and its symptoms include unbearable burning and sensitivity, muscle spasms, inflammation and problems with concentration and memory.
Like many pain management experts and despite the dearth of controlled studies, Getson uses ketamine off label. The most powerful of a set of anesthetics known as the NMDA (for N-methyl-D-aspartate) antagonists, ketamine blocks the sensitization process in the central nervous system, allowing pain cells to normalize.
Despite its awful symptoms, complex regional pain syndrome (also called reflex sympathetic dystrophy) remains difficult to diagnose. While the nonprofit RSDHope estimates 1.5 to 3 million with the syndrome in the United States, Getson believes that's a gross undercount, and that the true number is closer to 6 million, with women experiencing it disproportionately. More...
PainCareMD
www.miller-mccune.com
Janice Arenofsky
Ketamine has captivated physicians and teens ever since 1970 when the FDA approved the drug as a surgical anesthesia, and young adults started getting high on it. First marketed as a veterinary anesthetic, ketamine — which is chemically related to PCP and encourages psychological and physical dependence — quickly caught on with drug abusers. By 1981 the U.S. Department of Health and Human Services recommended ketamine's reclassification as a controlled substance, but the DEA rejected the idea until 1992 when it received 775 reports of ketamine abuse, including veterinary clinic burglaries and hospital emergency room visits.
Despite an association with date rape and other hallucinatory drugs, infusions of ketamine now represent last-resort therapy for those with the intractable disease known as complex regional pain syndrome. The only drawback to treatment is patients literally may be betting their lives against this unorthodox, and potentially excessive, use of the drug.
"It's a crappy disease," said Philip Getson, clinical associate professor of neurology at Drexel University College of Medicine in Philadelphia. The syndrome ranks No. 1 in painful chronic conditions, according to the McGill Pain Index, and its symptoms include unbearable burning and sensitivity, muscle spasms, inflammation and problems with concentration and memory.
Like many pain management experts and despite the dearth of controlled studies, Getson uses ketamine off label. The most powerful of a set of anesthetics known as the NMDA (for N-methyl-D-aspartate) antagonists, ketamine blocks the sensitization process in the central nervous system, allowing pain cells to normalize.
Despite its awful symptoms, complex regional pain syndrome (also called reflex sympathetic dystrophy) remains difficult to diagnose. While the nonprofit RSDHope estimates 1.5 to 3 million with the syndrome in the United States, Getson believes that's a gross undercount, and that the true number is closer to 6 million, with women experiencing it disproportionately. More...
PainCareMD
Over-the-Counter Overdoses
October 1, 2009
emsresponder.com
Kevin Thomas Collopy, BA, CCEMT-P, NREMT-P, WEMT
Over-the-counter (OTC) drug abuse is on the rise. Since 2000 there has been a fourfold increase in abuse of cold medicine. Nonsteroidal anti-inflammatory drugs (NSAIDS) are the third most commonly intentionally overdosed medicine. Acetaminophen overdose is responsible for the greatest number of drug overdose hospital admissions in developed countries. Hundreds of different nonprescription medicines are available.
Nonprescription medications are easy to obtain. Thus, they are appealing to youth: Adolescents are the most common over-the-counter drug abusers, and they often combine OTC drugs with street drugs and alcohol. Teen OTC drug abuse often occurs in fads, as groups of teens discover the effects of the drugs together.
Not all overdoses are intentional. Some are accidental, and many patients are at risk of greater adverse effects from regular doses of OTC drugs. For example, alcohol consumption creates a synergistic effect with many medications, especially NSAIDs. Patients over 60 additionally risk gastrointestinal bleeding from even regular doses of NSAIDs. GI bleeding can also develop from NSAID overdose when a patient is on blood thinners or has a history of ulcers.
As with many medical problems, the very young and very old suffer the worst consequences. Nearly half (46%) of all antihistamine overdoses involve children under 6. More...
PainCare MD
emsresponder.com
Kevin Thomas Collopy, BA, CCEMT-P, NREMT-P, WEMT
Over-the-counter (OTC) drug abuse is on the rise. Since 2000 there has been a fourfold increase in abuse of cold medicine. Nonsteroidal anti-inflammatory drugs (NSAIDS) are the third most commonly intentionally overdosed medicine. Acetaminophen overdose is responsible for the greatest number of drug overdose hospital admissions in developed countries. Hundreds of different nonprescription medicines are available.
Nonprescription medications are easy to obtain. Thus, they are appealing to youth: Adolescents are the most common over-the-counter drug abusers, and they often combine OTC drugs with street drugs and alcohol. Teen OTC drug abuse often occurs in fads, as groups of teens discover the effects of the drugs together.
Not all overdoses are intentional. Some are accidental, and many patients are at risk of greater adverse effects from regular doses of OTC drugs. For example, alcohol consumption creates a synergistic effect with many medications, especially NSAIDs. Patients over 60 additionally risk gastrointestinal bleeding from even regular doses of NSAIDs. GI bleeding can also develop from NSAID overdose when a patient is on blood thinners or has a history of ulcers.
As with many medical problems, the very young and very old suffer the worst consequences. Nearly half (46%) of all antihistamine overdoses involve children under 6. More...
PainCare MD
Thursday, October 8, 2009
Relieve Hip Pain Without Surgery
September 30, 2009
www.baltimoresun.com
Hip pain can be a sign of many medical conditions. Some disorders, such as severe arthritis could, in time, require a hip replacement. But others, such as bursitis, can be managed with much less invasive treatment options. Exercise may help in some situations, but not all. Before you pursue treatment for hip pain, or start an exercise program, I recommend you see your doctor to determine the exact cause of your discomfort.
Hip pain can result from disorders that affect the hip joint, or it may be a sign of a problem with the muscles, ligaments, tendons or other structures that support the joint. To diagnose the cause of your hip pain, your doctor will likely do a physical exam followed by an X-ray of the hip. In some cases, another imaging exam, such as an MRI, may be necessary, depending on your condition. For most people, the exam and imaging test is all that's needed to uncover the cause of hip pain.
One common cause of hip pain is osteoarthritis, a condition that occurs when cartilage in the joints wears down over time. Although osteoarthritis has no definitive cure and may eventually lead to joint replacement, many people can effectively reduce the pain of this condition with a combination of exercise, medication and, in some cases, corticosteroid injections.
For people who have arthritis, gentle exercise can help strengthen the muscles around the joints. When arthritis affects the hip joint, swimming, gentle water aerobics, or other low impact activities such as a stationary bicycle are often good exercise choices. Stretching and muscle strengthening exercises targeted to the hip also may help increase the range of motion in the hip joint and reduce pain. Activities that put sudden pressure or stress on the hip joints -- such as running and playing tennis -- are likely to make arthritis symptoms worse. If you are diagnosed with arthritis, talk with your doctor before starting an exercise program to find out what types of exercises are appropriate and to get specific instructions on exercises to avoid.
Another common cause of hip pain is bursitis, an inflammation of one of the small, fluid-filled sacs (bursas) that lubricate and cushion pressure points between the bones and the tendons and muscles near the joint. More...
PainCareMD
www.baltimoresun.com
Hip pain can be a sign of many medical conditions. Some disorders, such as severe arthritis could, in time, require a hip replacement. But others, such as bursitis, can be managed with much less invasive treatment options. Exercise may help in some situations, but not all. Before you pursue treatment for hip pain, or start an exercise program, I recommend you see your doctor to determine the exact cause of your discomfort.
Hip pain can result from disorders that affect the hip joint, or it may be a sign of a problem with the muscles, ligaments, tendons or other structures that support the joint. To diagnose the cause of your hip pain, your doctor will likely do a physical exam followed by an X-ray of the hip. In some cases, another imaging exam, such as an MRI, may be necessary, depending on your condition. For most people, the exam and imaging test is all that's needed to uncover the cause of hip pain.
One common cause of hip pain is osteoarthritis, a condition that occurs when cartilage in the joints wears down over time. Although osteoarthritis has no definitive cure and may eventually lead to joint replacement, many people can effectively reduce the pain of this condition with a combination of exercise, medication and, in some cases, corticosteroid injections.
For people who have arthritis, gentle exercise can help strengthen the muscles around the joints. When arthritis affects the hip joint, swimming, gentle water aerobics, or other low impact activities such as a stationary bicycle are often good exercise choices. Stretching and muscle strengthening exercises targeted to the hip also may help increase the range of motion in the hip joint and reduce pain. Activities that put sudden pressure or stress on the hip joints -- such as running and playing tennis -- are likely to make arthritis symptoms worse. If you are diagnosed with arthritis, talk with your doctor before starting an exercise program to find out what types of exercises are appropriate and to get specific instructions on exercises to avoid.
Another common cause of hip pain is bursitis, an inflammation of one of the small, fluid-filled sacs (bursas) that lubricate and cushion pressure points between the bones and the tendons and muscles near the joint. More...
PainCareMD
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