Joint Pain.

 

The safety of some osteoarthritis pain relievers has been questioned, but there are alternatives.

By Julia Tolliver Maranan  |  December 4, 2005

Osteoarthritis, that wear and tear on joints that causes pain, swelling, and stiffness, is just another natural sign of aging, says Dr. Jonathan Scott Coblyn, director of the Center for Arthritis and Joint Diseases at Brigham and Women's Hospital. The incidence of this condition increases as one ages, he says, and by age 50, an estimated 50 percent of people have osteoarthritis joint pain in at least one joint.

The search for a drug to combat the pain has been problem-plagued - and perhaps even dangerous - for some patients. Over-the-counter pain relievers such as aspirin, ibuprofen, and naproxen can cause ulcers and internal bleeding when taken long term. COX-2 inhibitors like Vioxx and Celebrex appeared to relieve inflammation while protecting the stomach, and that claim propelled the prescription painkillers to prominence, Coblyn says, "but there was never any evidence that they were better than ibuprofen or naproxen." There has been evidence that COX-2 inhibitors may increase the risk of heart attack and stroke; Merck , the maker of Vioxx, took the drug off the market last year, and court cases against the company are piling up. Celebrex remains on the market with a label warning about cardiovascular risks.

But a surprising, and important, thing to know is that you don't necessarily have to rely on drugs to reduce osteoarthritis pain. "The most important thing is weight loss," says Coblyn. "Every pound you lose takes about 3 or 4 pounds of pressure off your joints." Physical therapy may also help cushion the forces we place on our joints.

Coblyn also recommends taking glucosamine and chondroitin sulfate, over-the-counter supplements, for three to six months to see if they help. Preliminary results from the Glucosamine/Chondroitin Arthritis Intervention Trial, sponsored by the National Institutes of Health and the National Center for Complementary and Alternative Medicine, suggest that the combination of supplements is effective in treating moderate to severe joint pain due to osteoarthritis. "We don't know how it works or why," Coblyn says, "but there's some suggestion it may help stabilize cartilage loss."

Why Men Need a Date With Doc

Most men visit the doctor sporadically throughout their younger years (often only at the behest of their loved ones). But once a man turns 50, he should stop in once a year for a physical examination, says Dr. C. Christopher Smith, a specialist in internal medicine at Beth Israel Deaconess Medical Center. That's because the older a man gets, the more his risk for certain diseases - such as prostate and colorectal cancer, heart disease, and stroke - increases.

Scared of getting a diagnosis you don't want to hear? Remember that the earlier you catch a problem, the easier it is to treat (and by identifying your risk factors now, you may be able to prevent a medical condition from ever arising). Schedule an appointment, then ask for screenings for colon and prostate cancer and have your blood pressure and cholesterol tested. Also, "have a conversation with your doctor about diet, exercise, weight, smoking, and the risk versus benefit of aspirin use," says Smith.

Slumber More Sweetly

Research shows that getting plenty of sleep shores up both men's and women's defenses against problems like diabetes, high blood pressure, obesity, and a weakened immune system. But many people have trouble sleeping - and grow more susceptible to the effects of sleep deprivation - as they get older, says Dr. Sanford Auerbach, director of the Sleep Disorders Center at Boston Medical Center. Stress, chronic pain, certain medicines, hot flashes and night sweats, and even an increased need to use the bathroom can all contribute to sleeplessness or reduced-quality sleep.

So how can you get more rest? First, make your sleep environment relaxing and relatively free of distractions. Then, watch your caffeine intake (your sensitivity increases with age) and nix the nightcap, because it decreases your quality of sleep. If you suspect your medications of interfering with your sleep, talk to your doctor about alternatives. If stress is the culprit, Auerbach recommends getting regular exercise and using relaxation techniques, herbal remedies, or medications to tame tension. If these suggestions don't help, or an underlying factor is the issue, talk to your doctor. 

Knee Joint Pain and Glucosamine.