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Tips For Dealing With The Chronic Pain Of Osteoarthritis

Severe osteoarthritis of the hands

One of my patients came to see me today with severe right knee pain.  This is not a new problem, and in fact, we have been dealing with flare ups of her osteoarthritis for years.  It mainly affects her knees and hands and today her right knee was swollen and felt like the “bone was rubbing together” with each step. She could hardly walk because of the pain.

Osteoarthritis is also known as degenerative arthritis and it is one of the most common maladies of aging joints, affecting millions of people.  The cartilage in joints wears down and inflammation causes the bones to build up spurs and small micro tears.  It affects women more than men and  the cause is unknown.  There are likely genetic factors as it tends to run in families.  Arthritis can occur in any joint but the most common are the fingers, wrists, hips, neck and spine and knees.  Stiffness (especially in the morning) and pain are the main symptoms that limit mobility.

You can see Read more »

*This blog post was originally published at EverythingHealth*

Recognizing And Treating Carpal Tunnel Syndrome

Immediately Post-op Carpal Tunnel release

Carpal Tunnel Syndrome (CTS) is common and is the result of the median nerve becoming squeezed or “entrapped” as it passes through the wrist down into the palm of the hand.  Because this is a sensory nerve, the compression causes tingling, burning and itching numbness in the palm of the hand and fingers. A different nerve goes to the little finger and the lateral half of the 4th finger so the sensation there would feel normal.  There is often a sensation of swelling even though there is rarely any true edema that can be seen in CTS.

The symptoms of Carpal Tunnel Syndrome  usually start at night when people sleep with flexed wrists.  As it progresses, the tingling and numbness can be felt on and off during the day.  It can cause decreased grip strength and weakness in the hands.

CTS can be worsened by medical conditions like rheumatoid arthritis, diabetes, pregnancy or wrist trauma.  Women are three times more likely to develop CTS than men,  and it is rare in children.  Most of the time no cause is found.  The space that the median nerve traverses is very tiny and it doesn’t take much to compress the nerve.  Even small amounts of tissue swelling such as occurs in pregnancy can cause severe symptoms.

The treatment for Carpal Tunnel Syndrome starts with Read more »

*This blog post was originally published at EverythingHealth*

Use Of Prescription NSAIDS During Early Pregnancy Linked To Miscarriage?

A new study of more than 52,000 pregnant women in Canada shows that miscarriage rates were more than twice as high for women who took a nonsteroidal anti-inflammatory drug (NSAID) compared to women who did not.  The study, published in the Canadian Medical Association Journal reported that women who used prescription NSAIDS for just 4 days during early pregnancy had an increased risk for miscarriage.

These medications are commonly prescribed for pain, cramps, headaches and fever and can be bought over the counter as Advil, Aleeve or Ibuprofen.  We have thought they were safe in early pregnancy but this study shows that may not be the case. Read more »

*This blog post was originally published at EverythingHealth*

Three Common Ailments That Can Be Treated With Regular Exercise

It’s Wednesday, so I would like to tell you about some cool things I learned this past week about the science of how exercise can be used as a treatment for three common ailments.

First, some background about exercise: The great thing about exercising every day that you eat is that this magic potion is not a shot or a pill. It does not involve a doctor burning or squishing anything in your body. There are no HIPAA forms, no insurance pre-certifications, and not even a co-pay. It’s as we say, easy and free. And drum roll please…exercise is active—not passive.

Here’s the Mandrola take on how exercise might treat three specific medical conditions: Read more »

*This blog post was originally published at Dr John M*

NSAIDs Might Be Risky For People With Heart Problems

As if people with the combination of high blood pressure and heart disease don’t already have enough to worry about, a new study suggests that common painkillers called nonsteroidal anti-inflammatory drugs (NSAIDs) pose special problems for them.

Among participants of an international trial called INVEST, those who often used NSAIDs such as ibuprofen (Advil, Motrin and others), naproxen (Aleve, Naprosyn, and others), or celecoxib (Celebrex) were 47% more likely to have had a heart attack or stroke or to have died for any reason over three years of follow-up than those who used the drugs less, or not at all. The results were published in the July issue of the American Journal of Medicine.

Millions of people take NSAIDs to relieve pain and inflammation. They are generally safe and effective. The main worry with NSAIDs has always been upset stomach or gastrointestinal bleeding. During the last few years, researchers have raised concerns that Read more »

*This blog post was originally published at Harvard Health Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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