Osteoporosis Archive

Ask the doctors

Q. I'm in my early 50s and am considering a knee replacement for severe arthritis. I've heard that doctors typically encourage people to wait until after age 60 to perform this procedure. Should I wait to have the surgery?

A. Doctors do sometimes recommend that people under age 60 wait to undergo a knee replacement procedure, because these artificial joints typically last only about 15 to 20 years. If someone younger gets the procedure, it's likely that the joint will need to be replaced again down the line. That said, the decision to have a joint replacement really depends more on your individual circumstances, such as how much pain you have, whether the problem is causing you significant disability, and your overall health, not just how old you are. Some people can safely wait until they are 60 to undergo the procedure without a problem. For others, waiting too long to have the knee replaced might not be advised. For example, if the knee joint deteriorates too much, that may make the surgery to replace it more challenging. Over all, most people (80% to 90%) who do opt for a knee replacement are happy with the results of the procedure, but it's best to discuss the pros and cons with your doctor.

The first line of treatment for many knee and hip problems includes taking over-the-counter pain medications. Acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen are the most common pain medication options. However, these pain medications have a variety of side effects, so it's important to discuss your personal health risks with your doctor when considering long-term use for chronic conditions such as osteoarthritis.

Acetaminophen (Tylenol and other brands) is usually effective for mild pain and is easy on the stomach. However, it is toxic to the liver at high doses. The recommended maximum per day is generally set at 4 grams (4,000 milligrams), which is the equivalent of eight extra-strength Tylenol tablets. But that dosage can still cause liver problems for some people. To be safe, aim for 3,000 milligrams or less, and be cautious of mixing multiple products containing acetaminophen, such as a pain reliever and a cold medication or a prescribed narcotic.

If you've had a stone, the problem is likely to recur — but it doesn't have to. Use these strategies for prevention.

The pain associated with kidney stones has been described by some as more excruciating than childbirth. Kidney stones are small, hard stones, formed when high levels of minerals in your urine start to crystallize in your kidneys, forming a pebble-like mass. The pain comes when these stones migrate from your kidneys through the ureters, which are the narrow tubes that carry urine from your kidneys into your bladder.

"Kidney stone pain is not subtle," says Dr. Gary Curhan, a professor of epidemiology at the Harvard T.H. Chan School of Public Health. It typically starts in the flank, at the side of the lower back. Sometimes if the stone moves, the pain migrates to the front of the body.

Ask the doctors

Q. My friend was recently diagnosed with fibromyalgia, but it seems like she might be imagining her symptoms. Is fibromyalgia a real condition?

A. The short answer to your question is yes. Fibromyalgia is a real condition that affects some four million Americans. It's a chronic pain syndrome that experts believe may be caused by a malfunctioning nervous system. Researchers using magnetic resonance imaging to examine the brains of people with fibromyalgia have found abnormalities in the part of the brain that processes pain signals from the body. It appears that this part of the brain is essentially boosting the intensity of normal pain signals, potentially causing the body to feel pain without a physical cause.

Q . I've started to notice a slight shakiness in my writing hand. Is this just normal aging or should I get my shaky hands checked out?

A. If the shakiness is sudden or recent, you should talk to a doctor. It may be nothing serious—for example, just a reversible side effect from a medication or from too much caffeine. However, tremors could be an early sign of a more serious condition, like Parkinson's disease. In that case, you could benefit from early diagnosis and starting treatment.

Strength training is good for just about everyone. It's especially beneficial for people with arthritis. When properly done as part of a larger exercise program, strength training helps them support and protect joints, not to mention ease pain, stiffness, and possibly swelling. Yet, the thought of starting a weight training program can be daunting to many arthritis sufferers.

If you have arthritis and want to incorporate strength training into your health routine, these tips can help you get started.

An ad for an arthritis medication seems to suggest that taking it will alleviate or even eliminate morning stiffness, allowing you to hop out of bed. Like most drug ads, this one has unspoken messages and glosses over questions about side effects and cost.