Showing posts with label PainManagement. Show all posts
Showing posts with label PainManagement. Show all posts

Wednesday, October 28, 2026

How To Relieve Knee Pain From Osteoarthritis With Aerobic Exercise

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If you’re experiencing joint pain in the knees, the solution might be to walk it off. Aerobic exercise can reduce pain, improve movement and enhance quality of life for patients with knee osteoarthritis, according to a study published October 15 in the journal The BMJ. Around 1 in 5 adults, or 54 million people, are affected by some type of arthritis in the United States. The most common form is osteoarthritis.“Osteoarthritis is wear and tear of cartilage, or the covering at the end of bones, which leads to pain, stiffness and decreased joint function………Continue reading….

By: Gina Park

Source:  CNN

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Critics:

Knee pain is caused by trauma, misalignment, degeneration, and conditions producing arthritis. The most common knee disorder is generally known as patellofemoral syndrome. The majority of minor cases of knee pain can be treated at home with rest and ice, but more serious injuries do require surgical care.

One form of patellofemoral syndrome involves a tissue-related problem that creates pressure and irritation in the knee between the patella and the trochlea (patellar compression syndrome), which causes pain. The second major class of knee disorder involves a tear, slippage, or dislocation that impairs the structural ability of the knee to balance the leg (patellofemoral instability syndrome). Patellofemoral instability syndrome may cause either pain, a sense of poor balance, or both.

Prepatellar bursitis also known as housemaid’s knee is painful inflammation of the prepatellar bursa (a frontal knee bursa) often brought about by occupational activity such as roofing. Age also contributes to disorders of the knee. Particularly in older people, knee pain frequently arises due to osteoarthritis.

In addition, weakening of tissues around the knee may contribute to the problem. Patellofemoral instability may relate to hip abnormalities or to tightness of surrounding ligaments.

Cartilage lesions can be caused by:

  • Accidents (fractures)
  • Injuries
  • The removal of a meniscus
  • Anterior cruciate ligament injury
  • Posterior cruciate ligament injury
  • Posterolateral corner injury
  • Medial knee injuries
  • Considerable strain on the knee.

Any kind of work during which the knees undergo heavy stress may also be detrimental to cartilage. This is especially the case in professions in which people frequently have to walk, lift, or squat. Other causes of pain may be excessive on, and wear off, the knees, in combination with such things as muscle weakness and overweight.

Common complaints:

  • A painful, blocked, locked or swollen knee.
  • Sufferers sometimes feel as if their knees are about to give way, or may feel uncertain about their movement.

Physical fitness is related integrally to the development of knee problems. The same activity such as climbing stairs may cause pain from patellofemoral compression for someone who is physically unfit, but not for someone else (or even for that person at a different time).

Obesity is another major contributor to knee pain. For instance, a 30-year-old woman who weighed 120 pounds (54 kg) at age 18 years, before her three pregnancies, and now weighs 285 pounds (129 kg), had added 660 pounds (300 kg) of force across her patellofemoral joint with each step.

Knee osteoarthritis is a major cause of pain and disability worldwide, with prevalence estimated at about 4% of the population, particularly among the elderly. Radiofrequency ablation of certain knee nerves is an outpatient procedure to reduce chronic arthritic pain. Using radiofrequency energy delivered via small electrodes positioned at target genicular nerves, the treatment achieves partial sensory denervation of the joint capsule.

Despite the extensive innervation of the knee, specifically targeting the superior lateral, superior medial, and inferior medial genicular nerves has proved to be an effective ablation method for reducing chronic knee pain. In clinical research, such treatment has been shown to produce about 50% less knee pain for up to two years after the procedure.

Anatomy of Knee”.

Flexion contracture of the knee”. 

Flexion contracture of the knee: The mechanics of the muscular contracture and the turnbuckle cast method of treatment; with a review of fifty-five cases. 1932″. 

Occupational kneeling and radiographic tibiofemoral and patellofemoral osteoarthritis”. 

Tibiofemoral and Patellofemoral Kinematics After Reconstruction of an Isolated Posterior Cruciate Ligament Injury: In Vivo Analysis During Lunge”.

The effect of tibiofemoral loading on proximal tibiofibular joint motion”.

Differential Diagnosis in Magnetic Resonance Imaging.

Posterolateral Corner of the Knee: Current Concepts”.

Do babies have kneecaps?”. 

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Osteoarthritis ,ExerciseForPainRelief ,JointHealth ,OsteoarthritisAwareness ,HealthyJoints ,MoveBetter ,StayActive ,PainManagement ,OsteoarthritisSupport ,PhysicalTherapy ,FitWithOsteoarthritis ,JointFriendlyExercises ,ChronicPainRelief ,GetMoving ,InjuryPrevention ,LifestyleChanges ,HealthyLiving

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Saturday, October 17, 2026

How Psychological Stress Can Trigger Arthritis Flares Via An Inflammatory Pathway

How psychological stress triggers arthritis flares via an IL-6-dependent pathway

Psychological stress has long been associated with worsening symptoms in rheumatoid arthritis (RA). However, the underlying mechanism connecting psychological stress to the occurrence of joint inflammation has remained poorly understood. In particular, how psychological stress can trigger inflammation in joints that were previously affected, even after the disease has gone into remission, remains an important unanswered question………Continue reading….

By Chiba University

Source: Medical Xpress

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Critics: 

Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are involved, with the same joints typically involved on both sides of the body. The disease may also affect other parts of the body, including skin, eyes, lungs, heart, nerves, and blood. This may result in a low red blood cell count, inflammation around the lungs, and inflammation around the heart.

Fever and low energy may also be present. Often, symptoms come on gradually over weeks to months. While the cause of rheumatoid arthritis is not clear, it is believed to involve a combination of genetic and environmental factors. The underlying mechanism involves the body’s immune system attacking the joints. This results in inflammation and thickening of the joint capsule. It also affects the underlying bone and cartilage.

The diagnosis is made mostly on the basis of a person’s signs and symptoms. X-rays and laboratory testing may support a diagnosis or exclude other diseases with similar symptoms. Other diseases that may present similarly include systemic lupus erythematosus, psoriatic arthritis, and fibromyalgia among others.

The goals of treatment are to reduce pain, decrease inflammation, and improve a person’s overall functioning. This may be helped by balancing rest and exercise, the use of splints and braces, or the use of assistive devices. Pain medications, steroids, and NSAIDs are frequently used to help with symptoms. Disease-modifying antirheumatic drugs (DMARDs), such as hydroxychloroquine and methotrexate, may be used to try to slow the progression of disease.

Biological DMARDs may be used when the disease does not respond to other treatments. However, they may have a greater rate of adverse effects. Surgery to repair, replace, or fuse joints may help in certain situations. RA affects about 24.5 million people as of 2015. This is 0.5–1% of adults in the developed world with between 5 and 50 per 100,000 people newly developing the condition each year. Onset is most frequent during middle age and women are affected 2.5 times as frequently as men.

It resulted in 38,000 deaths in 2013, up from 28,000 deaths in 1990. The first recognized description of RA was made in 1800 by Dr. Augustin Jacob Landré-Beauvais (1772–1840) of Paris. The term rheumatoid arthritis is based on the Greek for watery and inflamed joints. RA primarily affects joints, but it also affects other organs in more than 15–25% of cases. Associated problems include cardiovascular disease, osteoporosis, interstitial lung disease, infection, cancer, feeling tired, depression, mental difficulties, and trouble working.

Arthritis of joints involves inflammation of the synovial membrane. Joints become swollen, tender and warm, and stiffness limits their movement. With time, multiple joints are affected (polyarthritis). Most commonly involved are the small joints of the hands, feet and cervical spine, but larger joints like the shoulder and knee can also be involved. Synovitis can lead to tethering of tissue with loss of movement and erosion of the joint surface causing deformity and loss of function.

The fibroblast-like synoviocytes (FLS), highly specialized mesenchymal cells found in the synovial membrane, have an active and prominent role in these pathogenic processes of the rheumatic joints. RA typically manifests with signs of inflammation, with the affected joints being swollen, warm, painful and stiff, particularly early in the morning on waking or following prolonged inactivity. Increased stiffness early in the morning is often a prominent feature of the disease and typically lasts for more than an hour.

Gentle movements may relieve symptoms in early stages of the disease. These signs help distinguish rheumatoid from non-inflammatory problems of the joints, such as osteoarthritis. In arthritis of non-inflammatory causes, signs of inflammation and early morning stiffness are less prominent. The pain associated with RA is induced at the site of inflammation and classified as nociceptive as opposed to neuropathic.

The joints are often affected in a fairly symmetrical fashion, although this is not specific, and the initial presentation may be asymmetrical. As the pathology progresses the inflammatory activity leads to tendon tethering and erosion and destruction of the joint surface, which impairs range of movement and leads to deformity. The fingers may develop almost any deformity depending on which joints are most involved.

Specific deformities, which also occur in osteoarthritis, include ulnar deviation, boutonniere deformity (also “buttonhole deformity”, flexion of proximal interphalangeal joint and extension of distal interphalangeal joint of the hand), swan neck deformity (hyperextension at proximal interphalangeal joint and flexion at distal interphalangeal joint) and “Z-thumb.”

“Z-thumb” or “Z-deformity” consists of hyperextension of the interphalangeal joint, fixed flexion and subluxation of the metacarpophalangeal joint and gives a “Z” appearance to the thumb. The hammer toe deformity may be seen. In the worst case, joints are known as arthritis mutilans due to the mutilating nature of the deformities. Worldwide, RA affects approximately 1% of the adult population and occurs in one in 1,000 children. Studies show that RA primarily affects individuals between the ages of 40–60 years and is seen more commonly in females.

A family history of RA increases the risk around three to five times; as of 2016, it was estimated that genetics may account for 40–65% of cases of seropositive RA, but only around 20% for seronegative RA. RA is strongly associated with genes of the inherited tissue type major histocompatibility complex (MHC) antigen. HLA-DR4 is the major genetic factor implicated – the relative importance varies across ethnic groups. Genome-wide association studies examining single-nucleotide polymorphisms have found around one hundred alleles associated with RA risk. 

Risk alleles within the HLA (particularly HLA-DRB1) genes harbor more risk than other loci.The HLA encodes proteins that control recognition of self- versus non-self molecules. Other risk loci include genes affecting co-stimulatory immune pathways—for example CD28 and CD40, cytokine signaling, lymphocyte receptor activation threshold (e.g., PTPN22), and innate immune activation—appear to have less influence than HLA mutations.

Despite the strong genetic components of the disease, identical twin studies have shown only 12-15% concordance for twins raised in separate households. This indicates that rheumatoid arthritis most likely results from a combination of genetic and environmental factors, in a majority of cases.

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Sunday, September 13, 2026

Tylenol Can Be Made Without Coal Tar and Crude Oil

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The popular pain-killing drug paracetamol, also known as acetaminophen, has always been made from chemicals derived from environmentally damaging coal tar or crude oil. Now researchers have devised a greener way of producing the drug using wood from the poplar tree. First synthesized in the 1800s, paracetamol, known in the US and Japan as acetaminophen, is one of the most commonly used over-the-counter drugs for pain and fever in the world. Sold as Tylenol and Panadol, it even appears on the World Health Organization’s Model List of Essential Medicines……..Continue reading..

By Paul McClure

Source: Refractor

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Critics:

Analgesics are frequently used in combination, such as the paracetamol and codeine preparations found in many non-prescription pain relievers. They can also be found in combination with vasoconstrictor drugs such as pseudoephedrine for sinus-related preparations, or with antihistamine drugs for people with allergies.

While the use of paracetamol, aspirin, ibuprofen, naproxen, and other NSAIDs concurrently with weak to mid-range opioids (up to about the hydrocodone level) has been said to show beneficial synergistic effects by combating pain at multiple sites of action, several combination analgesic products have been shown to have few efficacy benefits when compared to similar doses of their individual components.

Moreover, these combination analgesics can often result in significant adverse events, including accidental overdoses, most often due to confusion that arises from the multiple (and often non-acting) components of these combinations. There is some evidence that some treatments using alternative medicine can relieve some types of pain more effectively than placebo. The available research concludes that more research would be necessary to better understand the use of alternative medicine.

Nefopam—a monoamine reuptake inhibitor, and calcium and sodium channel modulator—is also approved for the treatment of moderate to severe pain in some countries. Flupirtine is a centrally acting K+ channel opener with weak NMDA antagonist properties. It was used in Europe for moderate to strong pain, as well as its migraine-treating and muscle-relaxant properties.

It has no significant anticholinergic properties, and is believed to be devoid of any activity on dopamine, serotonin, or histamine receptors. It is not addictive, and tolerance usually does not develop. However, tolerance may develop in some cases. Ziconotide, a blocker of potent N-type voltage-gated calcium channels, is administered intrathecally for the relief of severe, usually cancer-related pain.

Certain drugs that have been introduced for uses other than analgesics are also used in pain management. Both first-generation (such as amitriptyline) and newer antidepressants (such as duloxetine) are used alongside NSAIDs and opioids for pain involving nerve damage and similar problems. Other agents directly potentiate the effects of analgesics, such as using hydroxyzine, promethazine, carisoprodol, or tripelennamine to increase the pain-killing ability of a given dose of opioid analgesic.

Adjuvant analgesics, also called atypical analgesics, include orphenadrine, mexiletine, pregabalin, gabapentin, cyclobenzaprine, hyoscine (scopolamine), and other drugs possessing anticonvulsant, anticholinergic, and/or antispasmodic properties, as well as many other drugs with CNS actions. These drugs are used along with analgesics to modulate and/or modify the action of opioids when used against pain, especially of neuropathic origin.

Dextromethorphan has been noted to slow the development of and reverse tolerance to opioids, as well as to exert additional analgesia by acting upon NMDA receptors, as does ketamine. Some analgesics such as methadone and ketobemidone and perhaps piritramide have intrinsic NMDA action. The anticonvulsant carbamazepine is used to treat neuropathic pain. Similarly, the gabapentinoids gabapentin and pregabalin are prescribed for neuropathic pain, and phenibut is available without prescription.

Gabapentinoids work as α2δ-subunit blockers of voltage-gated calcium channels, and tend to have other mechanisms of action as well. Gabapentinoids are all anticonvulsants, which are most commonly used for neuropathic pain, as their mechanism of action tends to inhibit pain sensation originating from the nervous system. Topical analgesia is generally recommended to avoid systemic side-effects.

Painful joints, for example, may be treated with an ibuprofen- or diclofenac-containing gel (The labeling for topical diclofenac has been updated to warn about drug-induced hepatotoxicity.); capsaicin also is used topically. Lidocaine, an anesthetic, and steroids may be injected into joints for longer-term pain relief. Lidocaine is also used for painful mouth sores and to numb areas for dental work and minor medical procedures.

In February 2007 the FDA notified consumers and healthcare professionals of the potential hazards of topical anesthetics entering the bloodstream when applied in large doses to the skin without medical supervision. These topical anesthetics contain anesthetic drugs such as lidocaine, tetracaine, benzocaine, and prilocaine in a cream, ointment, or gel.

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