Electro-Accupuncture Relieving Knee Pain
January 22, 2010
Reuters
The study, published in the journal Pain, looked at the effects of electro-acupuncture among 40 adults with knee osteoarthritis — the common “wear-and-tear” form of arthritis in which the cartilage cushioning the joints breaks down.
Electro-acupuncture is similar to traditional acupuncture, where fine needles are inserted into specific points in the skin. What’s different is that the practitioner fits the needles with clips that are attached to a small device that delivers a continuous electrical impulse to stimulate the acupuncture point.
Among the patients in the current study, those who had a daily electro-acupuncture session for 10 consecutive days reported greater improvement in their pain compared with patients who received a “sham” version of the therapy.
Patients in that latter group received acupuncture, but the needles were inserted at random points on the skin rather than traditional acupuncture sites. And while the needles were attached to the electrical device, it was not actually turned on.
The findings suggest that true electro-acupuncture may offer at least short-term pain relief to knee arthritis sufferers, according to the researchers, led by Dr. Sadia Ahsin of the Army Medical College Rawalpindi in Pakistan.
Acupuncture has been used for more than 2,000 years in Chinese medicine to treat a wide variety of ailments. According to traditional medicine, specific acupuncture points on the skin are connected to internal pathways that conduct energy, or qi (“chee”), and stimulating these points with a fine needle promotes the healthy flow of qi.
Modern research has suggested that acupuncture may help ease pain by altering signals among nerve cells or affecting the release of various chemicals of the central nervous system, such as pain-killing endorphins.
In their study, Ahsin and colleagues found that electro-acupuncture appeared to raise patients’ blood levels of endorphins and lower their levels of the hormone cortisol, which tends to rise during physical or mental stress. So it’s possible that these changes explain the greater pain relief, according to the researchers.
Larger, longer-term studies are still needed to see whether electro-acupuncture can have lasting benefits — and to find out how often patients would need treatment to gain those benefits.
For now, Ahsin’s team writes, the current findings suggest that, for people who are interested in trying it, electro-acupuncture can be added to conventional treatment for knee arthritis.
Acupuncture and electro-acupuncture are generally regarded as low-risk therapies. Among patients in this study, there were no major side effects apart from bruising at the needle site in three patients, the researchers note.
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Running Shoes Could Cause Joint Strain
January 13, 2010
FoxNews.com
Running shoes, decked out with the latest cushioning, motion control and arch support technologies, may not be as beneficial to your feet and joints as you might think.
A new study finds that running shoes, at least the kind currently on the market, may actually put more of a strain on your joints than if you were to run barefoot or even to walk in high-heeled shoes, and the increased pressure could lead to knee, hip and ankle damage. The scientists don’t recommend ditching your high-tech sneaks, however, as going barefoot on man-made surfaces could also prove harmful.
While exercise is no doubt beneficial for overall health, running and walking put stresses on your joints that may predispose you to getting osteoarthritis in those areas, said Dr. D. Casey Kerrigan, who conducted the study while at the University of Virginia, where she was a professor of physical medicine and rehabilitation. Osteoarthritis is the breakdown of cartilage in your joints, which can lead to bone rubbing on bone, causing pain, Kerrigan explained. Walkers and runners should try to minimize forces on their joints to prevent this damage, she said.
In pervious work, Kerrigan and colleagues had shown that women’s high-heeled shoes cause an increase in pressure on the knee joint, specifically in areas where osteoarthritis typically develops, compared with walking barefoot. Since cushioning in running shoes can also create a slightly elevated heel, Kerrigan decided to investigate whether or not these shoes also increase these potentially damaging forces.
Running on a “bathroom scale”
The study enrolled 37 women and 31 men who ran recreationally, at least 15 miles (24 km) per week. The subjects were then studied in a “gait laboratory,” running either barefoot or with a typical running shoe. The subjects had markers on their knees, hips and ankle joints, and as they ran, cameras picked up these markers, allowing the researchers to see how the joints moved.
The subjects ran on a treadmill that contained a forceplate, a device Kerrigan describes as a “glorified bathroom scale.” With each step, the forceplate provided measurements of the magnitude of their bodyweight forces on the joints, and the direction of those forces.
They specifically looked at torque, twisting force, which in this case mainly came from the participants’ bodyweight, For example, if you stand on one leg, your bodyweight would put more pressure on the inside part of your knee than on the outside part, causing a torque at the knee, Kerrigan explained.
The researchers found an increase in this torque for the knees, hips and ankles when the participants were wearing running shoes as compared with when they were running barefoot.
Specifically, they saw a 38 percent increase in torque in areas of the knee where osteoarthritis develops, Kerrigan said. Such a large increase was surprising, she said, because it was greater than the increase in knee torque she had observed for women wearing high heels, which was only 20 percent to 26 percent.
Kerrigan noted the study only provides an estimate of the joint forces, and not the exact forces, because the methods used do not directly measure the forces inside the knee and other joints. However, there are other studies to support that these types of estimates do match up fairly well with the actual forces inside the joints.
Is barefoot better?
Should you ditch your running shoes altogether? While the results might seem to suggest that you should go barefoot – a way of running that has recently become popular thanks to the best-selling book “Born to Run,” by Christopher McDougall, in which the author argues that barefoot running is better for you – Kerrigan says that’s not the case.
“I’m concerned, I don’t think this study should promote running barefoot,” she said. “I think people should run in what they feel most comfortable running in … and whether that’s in a pair of running shoes or in a minimum kind of running shoe, that’s just fine.”
The problem with running sans shoes is that most of the man-made surfaces we run on are not “compliant” – they don’t give, or compress, at the right time to absorb the peak forces on your joints, Kerrigan said.
“We’ve evolved to run on compliant surfaces, not on asphalt or concrete,” she said. “You run on something hard, your body has to work that much harder to help absorb those forces, and that can lead to stresses and strain, wear and tear, really throughout the whole body.”
Also, while certain aspects of shoes, such as arch support, may not be the best for your knee joints, they do protect the foot itself, and may help prevent other injuries, such as shin splints, Kerrigan said.
Kerrigan does have what she believes is a better running shoe system in mind that she thinks would help to minimize the harmful joint torques. She is currently developing her patented shoe design through JKM Technologies, LLC, a manufacturing and information technology service company of which Kerrigan is chairman.
The results were published in the Dec. 2009 issue of the PM&R, the journal of American Academy of Physical Medicine and Rehabilitation.
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FDA Cancels Panel Review of Lilly Antidepressant
January 6, 2010 by Andrew
Filed under Government
January 06, 2010
ABC News
The Food and Drug Administration has canceled a meeting to review Eli Lilly & Co.’s antidepressant Cymbalta for a new use against chronic pain.
The agency said in a statement Tuesday that the Jan. 28 meeting was canceled “to allow time for the FDA to review new information,” about the proposed use.
Lilly shares fell 82 cents, or 2.3 percent, to $35 in afternoon trading.
Calls placed to Lilly Tuesday were not immediately returned. The company is based in Indianapolis.
Lilly withdrew an application in November 2008 after FDA reviewers questioned the methodology and dosing in some of the company’s trials.
The company submitted a new application last summer that included a study of Cymbalta for chronic pain caused by osteoarthritis, along with new data from a study of lower back pain.
Cymbalta is already approved to treat depression, generalized anxiety disorder, diabetic nerve pain and the pain ailment fibromyalgia.
The drug is Lilly’s second-best selling product, behind the anti-psychotic Zyprexa. Cymbalta generated $2.24 billion in sales through the first three quarters of 2009.
Lilly faces the loss of patents protecting several of its top selling drugs in the next few years. The patent protecting Zyprexa, which generated more than $4 billion in 2008, expires in 2011. Cymbalta’s patent expires in 2013.
Martial Arts – Fighting Arthritis
November 06, 2005
Guardian
The traditional Chinese exercise of Tai Chi can relieve the pain of arthritis of the knee, according to a new study. After a 12-week course of Tai Chi, people also had less difficulty with everyday tasks such as using the stairs.
What do we know already?
Osteoarthritis of the knee is very common in older adults. Among those over the age of 55, an estimated 10 percent have frequent knee pain caused by this joint disease, which can also lead to stiffness, limited movement, and a decreased quality of life.
Many people rely on painkillers to cope with the pain of osteoarthritis. Although exercise and physiotherapy can help, the improvements are often modest. However, specialists think Tai Chi is one type of exercise that might be particularly helpful.
Tai Chi features slow, rhythmic movements designed to bring about mental relaxation and enhance balance, strength, and flexibility. For people with osteoarthritis of the knee, this mind-body focus might improve their physical symptoms as well as helping them cope better mentally. Researchers have done a long-term study to learn more.
What does the new study say?
The study compared two groups of people aged 55 or older. One group met twice weekly for Tai Chi classes. The other group met twice weekly for general wellness instruction and stretching exercises. Both groups were asked to practise their exercises at home for at least 20 minutes a day.
At the end of 12 weeks, people in the Tai Chi group had a 75 percent drop in their pain, on average, and a 72 percent improvement in their ability to do everyday tasks (such as using stairs). People in the wellness and stretching group also reported improvements, but these were much lower than in the Tai Chi group.
The researchers used questionnaires to score people’s symptoms, as well as their mental state, quality of life, and other indicators of wellbeing. Besides doing better on pain and physical function, the Tai Chi group also had greater improvements in depression and overall health.
The researchers followed up with participants 24 and 48 weeks after the start of the study. Less than half of the people in each group still did their exercises at 48 weeks, and much of the differences between the groups had diminished by this time. However, the Tai Chi group continued to have significantly better depression scores, suggesting these improvements might be longer lasting.
Why Apples, Avocados and Red Wine Could Ease Your Arthritis
June 22, 2009
UK Daily Mail
Arthritis is the term used for nearly 200 painful conditions of the joints and bones. It affects about 7million people in the UK and all types have similar symptoms of swelling, inflammation of joints, stiffness and restriction of movement.
The good news is that many cases of arthritis can be relieved, postponed or even prevented by good joint care.
Research shows a definite link between the food you eat and the severity of your symptoms. Like your heart, your joints thrive best on plenty of fresh fruit and vegetables. Try to eat at least five (and preferably eight or more) servings a day.
Fruit and vegetables provide an array of antioxidants that reduce the rate at which cartilage breaks down, helping to slow the process of osteoarthritis. Antioxidants can also reduce inflammation and help combat rheumatoid arthritis, psoriatic arthritis and gout.
Apples and avocados are anti-inflammatory superfoods. Don’t peel your apples – the skin contains five times more antioxidants than the flesh. Oily fish are a rich source of omega-3 essential fatty acids that oil the joints and damp down inflammation.
Research shows that omega-3 can reduce the long-term need for painkillers in those with joint problems. You should aim to eat oily fish such as salmon, sardines, herrings and mackerel two to four times a week. You can also take an omega-3 fish oil supplement.
Drink plenty of fluids – approximately three to five pints (two to three litres) – a day to maintain good hydration and a steady flow of nutrients to your joints. Choose from water, soups, tea and juices.
You may find your symptoms are triggered by particular foods. Culprit foods vary, so it’s important to keep a food-and-symptom diary to help pinpoint the foods that irritate. This is not always easy, as symptoms can worsen up to 36 hours after eating a trigger food.
The foods most commonly found to worsen arthritis are wheat, corn, rye, sugar, caffeine, yeast, malt, dairy products, oranges, grapefruit, lemons and tomatoes. Meats most likely to provoke symptoms are bacon, pork, beef and lamb.
A number of foods may trigger joint pain in those with arthritis. Research shows that when these are avoided, about 70 per cent of sufferers report less pain and improved mobility.
Some are particularly sensitive to foods from the nightshade (Solanaceae) family. Commonly eaten nightshade foods include potatoes, tomatoes, aubergine, sweet peppers, paprika, cayenne and all other types of pepper (except black pepper).
Try to minimise your intake of vegetable oils rich in omega-6, such as sunflower oil, because these promote inflammation. Switch to olive oil for cooking, and macadamia nut oil or walnut oil for salad dressings.
Studies have also shown an association between the amount of meat and offal consumed and arthritis.
Eating a vegan (no animal products) diet can reduce the number of tender and swollen joints.
Weight loss is one of the most effective ways to reduce pain in your knees and hips, whatever form of arthritis you have. When you walk, the load on your knees increases by four times your body weight. This means that if you are 10lb (4.5kg) overweight, the load on your leg joints is up to 40lb (18kg) more than if you were at a healthy weight.
Studies show that weight loss can at least halve the level of pain experienced by those with arthritis affecting their lower limbs – this is a better result than standard drug treatments.
The foods below have a natural anti-inflammatory action that’s particularly beneficial for those with arthritis – however, some (such as chilli peppers) may trigger an idiosyncratic reaction in some sufferers:
Apples: Contain anti-inflammatory antioxidants. Red Delicious apples contain the most. The antioxidants are five times more concentrated in the apple’s skin than the flesh.
Avocados: Contain antioxidant monounsaturated oils, essential fatty acids and Vitamin E. Promote cartilage repair in osteoarthritis.
Chillies: Contain capsaicin and dihydrocapsaicin which block transmission of pain messages. They also trigger endorphins - the brain’s own morphine-like painkillers.
Dark green leafy vegetables: Broccoli, spinach, cabbage and parsley, for example, supply antioxidants, Vitamin C, calcium and magnesium.
Macadamia nuts: The richest source of monounsaturated fatty acids. Also contain Vitamin E and selenium.
Oily fish: A great source of omega-3 fatty acids.
Red wine: A good source of antioxidant polyphenols which reduce inflammation.
Walnuts: A rich source of omega-3 fatty acids. Some research shows that eating them daily can help alleviate the symptoms of rheumatoid arthritis
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