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Pain and Arthritis Newsletter
January 26, 2009

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In This Issue
• Knee Replacement Works Best When Patients, Providers Agree
• Rheumatoid Arthritis Hits Women Harder
• Health Tip: Help Manage Back Pain


Knee Replacement Works Best When Patients, Providers Agree


MONDAY, Jan. 19 (HealthDay News) -- People with severe osteoarthritis tend to be happier with their care and treatment if they see eye-to-eye with their health-care providers on the issue of total knee replacement, a new study finds.
However, about 20 percent of patients don't agree with providers when it comes to this common treatment. Osteoarthritis affects more than 20 million Americans, experts say.
The study, published in the January issue of Arthritis & Rheumatism (Arthritis Care & Research), found agreements between most providers and patients about the importance and potential benefits of the joint replacement surgery, but patients generally had greater concerns about the severity of their condition and possible complications.
"Discrepancies in provider-patient beliefs about the risks, benefits and need for TKR [total knee replacement] are not only a barrier to informed decision-making, but such differences also can affect post-consultation outcomes," study author Richard L. Street Jr., of Texas A&M University, said in a news release from the journal.
The researchers questioned 27 health-care providers and 74 patients with severe osteoarthritis about their views on the need for, risks of, and benefits of the surgery.
The findings indicated that patients who were more in agreement with their providers about the pros and cons of total knee replacement ended up happier with the care they received. They were also more likely to follow the provider's recommendations on treatment.
The authors suggest that the two parties in the study may have discussed the procedure at length without fully talking about why it was even necessary.
"More research is needed on effective information-giving, so that all the requirements of informed decision-making are met," the researchers said.
More information
The U.S. Centers for Disease Control and Prevention has more about osteoarthritis.



Rheumatoid Arthritis Hits Women Harder


FRIDAY, Jan. 16 (HealthDay News) -- Rheumatoid arthritis (RA) might affect women more often and more severely than men, new research suggests.
In a study of more than 6,000 people from around the world who had RA, about 79 percent of them women, Finnish researchers found that women had poorer outcomes in key measures such as symptoms and severity, especially in areas based on their responses to questionnaires.
The findings appear in the online journal Arthritis Research and Therapy.
"Obvious differences between genders exist in the prevalence, age at onset and level of production of harmful arthritis autoantibodies," study leader Tuulikki Sokka, a rheumatology consultant at Jyväskylä Central Hospital in Finland, said in a news release issued by the journal. "Furthermore, women report more symptoms and poor scores on most questionnaires, including scores for pain, depression, and other health-related items."
Some gender differences, though, stem from how disease activity is measured rather than from the disease itself, Sokka said.
"Women have less strength than men, which has as much of a major effect in the functional status of patients with RA as it does in the healthy population," Sokka said. "In fact, the gender differences in musculoskeletal performance remain, even among the fittest individuals." That's why, she said, male and female athletes generally don't compete against one another.
"Given that [a] woman is the 'weaker vessel' concerning musculoskeletal size and strength, and her baseline values are lower than men's, the same burden of a musculoskeletal disease may appear to be more harmful to a woman than to a man," Sokka explained.
More information
The National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about rheumatoid arthritis.



Health Tip: Help Manage Back Pain


(HealthDay News) -- When you begin to feel back pain, resist the urge to stay in bed for a prolonged period. It's better to remain active, according to the University of Maryland Medical Center (UMMC).
As long as you don't have a serious underlying medical problem that's causing your pain, the UMMC offers these suggestions for how to tame it:
For the first few days, take it easier, but only for a few days. After that, gradually become more active until you're back to your regular routine.
Apply either heat or ice to your sore back -- whichever feels better. You can also alternate between the two, starting with ice for the first two or three days, followed by muscle-relaxing heat beginning the next day.
If it's OK with your doctor, take an over-the-counter pain reliever such as acetaminophen or ibuprofen.
Take a warm bath before bed to soothe your back and help you sleep.
Sleep with a pillow between your legs (if on your side), or under your knees (if on your back).




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