Pooch Peril: More Elderly Are Fracturing Bones While Dog Walking

Pooch Peril: More Elderly Are Fracturing Bones While Dog Walking

WEDNESDAY, March 6, 2019 (HealthDay News) — Walking the dog can be great exercise for seniors, but there could be one downside: bone fractures.

Fractures suffered by elderly Americans while walking their dogs have more than doubled in recent years, new research shows.

Still, taking your dog for a walk can also bring big health rewards, one joint specialist said.

“Pets can provide companionship for older adults, and the physical exercise from regularly walking a dog may improve other aspects of physical and psychological health,” said Dr. Matthew Hepinstall, who wasn’t involved in the new study.

“So, the risks of walking a dog should be balanced against potential benefits,” said Hepinstall, who helps direct joint surgery at Lenox Hill Hospital in New York City.

The new research was led by Kevin Pirruccio, a second-year medical student at the University of Pennsylvania. His team tracked national data and found that among people aged 65 and older, fractures associated with walking leashed dogs rose from about 1,700 cases in 2004 to almost 4,400 cases in 2017 — a 163 percent rise.

More than three-quarters of the fractures occurred in women, with hip and arm fractures being the most common. About half of all fractures occurred in the upper body, with fractures of the wrist, upper arm, finger and shoulder leading the way.

The most common type of fracture was a broken hip (17 percent). That’s cause for concern, Pirruccio’s team said, because the death rate linked to hip fractures in people older than 65 is close to 30 percent.

The researchers added that the study only involved data on fractures treated at emergency departments. The actual number of dog walking-related injuries among seniors might even be higher if injuries not typically seen in a hospital — for example, tendon or muscle tears — were factored in.

Why the rising rates of fractures tied to dog walking? The study authors theorized that increased pet ownership and a greater emphasis on physical activity for older adults may be driving the trend.

In a university news release, Pirruccio stressed that walking your pooch each day “has repeatedly demonstrated social, emotional and physical health benefits.” It’s also “a popular and frequently recommended activity for many older Americans seeking new ways to stay active,” he said.

On the other hand, “patients’ risks for falls must be factored into lifestyle recommendations in an effort to minimize such injuries,” Pirruccio said.

Hepinstall agreed.

“The take-home message for older adults and their families is that, when choosing to care for a pet, be sure to consider the strength and coordination of the older adult, and the size and expected behavior of the pet selected,” he advised.

Pet ownership and care may need to be re-assessed with age, Hepinstall added.

“When the mobility of older adults changes, they should be encouraged to re-evaluate their ongoing ability to care for any pets,” he said. “This will help ensure that the health and other needs of the adult and of the pet can be properly managed.”

The study was published March 6 in JAMA Surgery.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases offers advice on preventing falls and fractures.

SOURCES: Matthew Hepinstall, M.D., associate director, joint preservation & reconstruction, department of orthopaedic surgery, Lenox Hill Hospital, New York City; University of Pennsylvania, news release, March 6, 2019

Copyright ©2017 HealthDay. All rights reserved.
Is Your Hand Pain Arthritis, Carpal Tunnel or Something Else?

Is Your Hand Pain Arthritis, Carpal Tunnel or Something Else?

FRIDAY, March 1, 2019 (HealthDay News) — You use your hands nearly every minute of the day, so any time they hurt it’s important to find out why.

Certain conditions can affect people who do the same hand movements for hours every day. Repetitive strain injury can cause pain in muscles, nerves and tendons. Carpal tunnel syndrome swelling compresses a key nerve. The lesser known de Quervain’s tenosynovitis typically affects tendons on the inner sides of the wrist.

An autoimmune disease like rheumatoid arthritis often causes joint pain. Without treatment, it can lead to deformities in your hands. The wrist and finger joints are common targets of osteoarthritis, which occurs over time from normal wear-and-tear.

Treatment might start with an over-the-counter or prescription NSAID to temporarily relieve pain, but their long-term use has been linked to side effects such as liver or kidney damage and elevated heart attack risk.

Stronger medications may be needed to stop a degenerative disease like rheumatoid arthritis. Corticosteroid injections are an occasional option to reduce inflammation. Heat can ease stiffness while a cold pack can relieve soreness. If you have a chronic condition, an occupational therapist can teach you how to limit stress on joints when using your hands. During a flare, he or she might suggest a splint to stabilize your hand.

Sometimes surgery is needed. Dupuytren’s contracture, a thickening under the skin on the palm of the hand, can develop into firm lumps that cause fingers to bend inward. Unless lumps are removed early, it may be impossible to straighten fingers later on. If other options don’t help carpal tunnel and de Quervain’s, surgery might be the answer.

Many conditions worsen without appropriate treatment, so don’t delay in seeing your doctor or a hand specialist.

More information

The American Academy of Orthopaedic Surgeons has more on painful hand conditions.

Copyright ©2017 HealthDay. All rights reserved.
Health Tip: What to Eat if You Have Arthritis

Health Tip: What to Eat if You Have Arthritis

f you have arthritis, there are foods that may help you feel better.

A diet that’s rich in vitamins and minerals, and includes fruits, lean proteins, fish, vegetables, nuts and healthy oils may be most beneficial, the foundation says.

But it cautions against changing too much, too soon. Gradually swap out ingredients at each meal, and you may feel a big difference in how you feel and how well you can manage your pain and discomfort, the foundation adds.

Copyright ©2017 HealthDay. All rights reserved.
Brisk Walks May Help, Not Harm, Arthritic Knees

Brisk Walks May Help, Not Harm, Arthritic Knees

If you suffer from knee arthritis and worry that walking will only worsen your damaged joint, a new study suggests you put your fears aside, slip on some sneakers, and take a brief but brisk walk.

The researchers estimated that if older adults with the condition added just 5 minutes of brisk walking to their day, their odds of needing knee replacement surgery could dip by 16 percent.

On the other hand, light walking — akin to a “stroll” — may have no impact, said lead researcher Hiral Master, a Ph.D. candidate in biomechanics and movement sciences at the University of Delaware.

Her team reached those conclusions by digging into data from over 1,800 older adults with knee arthritis who wore portable devices that tracked their walking intensities for at least four days.

Over the next five years, 6 percent of the participants had total knee replacement surgery.

The researchers used the data on people’s walking habits to examine the effects of replacing “non-walking” time with time spent walking at different intensities. The findings showed that substituting just 5 minutes of down time with moderate-to-high intensity walking was linked to a 16 percent decline in the odds of needing knee replacement surgery.

The study authors defined “moderate-to-high” intensity as more than 100 steps per minute. In laymen’s terms, Master said, that’s a “brisk” walk that gets your heart rate up — not a stroll around the block.

The findings were presented Saturday at the American College of Rheumatology’s annual meeting, in Chicago. Such research should be considered preliminary until published in a peer-reviewed journal.

Knee osteoarthritis develops when the cartilage cushioning the joint gradually breaks down, which can eventually result in bone scraping on bone.

The condition is common among middle-aged and older Americans. According to the Arthritis Foundation, up to 13.5 percent of men and 19 percent of women aged 45 and older have knee arthritis that’s severe enough to cause pain and other symptoms.

And those patients often wonder whether walking is good or bad for their arthritic joints, said Dr. Paul Sufka, a rheumatologist at the University of Minnesota, in Minneapolis.

“They often ask whether they should minimize their activity, keep doing what they’re doing, or intensify,” said Sufka, who is also with the American College of Rheumatology’s communications committee.

“The general advice we give to patients is to stay active,” Sufka said. But, he added, the truth is there is too little evidence to give patients definitive recommendations.

The new findings do not prove that brisk walking directly lowers the risk of needing knee replacement surgery, Sufka noted.

But, “this gives us some useful information to bring to the discussion,” he added.

Overall, Sufka said, research does suggest it’s better for people with knee arthritis to be active rather than sedentary. And that’s not just for the sake of their knees. Physical activity has a range of health benefits, including lower risks of heart attack and stroke.

Master agreed, and pointed out that exercise can help arthritis patients’ mental well-being, as well as physical.

And it doesn’t take a huge lifestyle change, she explained. The new findings suggest people can benefit from adding a short, brisk walk to their day.

In fact, Sufka said, such incremental shifts may be best.

“The best exercise program is the one you can actually stick with,” he said. “If right now, you’re walking around the block every day, what would be 5 percent or 10 percent more than that? You can gradually build from where you are.”

And what if walking is painful? That’s a tricky question, Sufka acknowledged. Some patients might benefit from physical therapy rather than only exercising on their own, he said.

Beyond aerobic exercise like walking, strengthening exercises for the leg muscles supporting the knees can also be helpful, he suggested.

More information

The Arthritis Foundation has an overview on knee arthritis.

SOURCES: Hiral Master, P.T., M.P.H., Ph.D. candidate, biomechanics and movement sciences, University of Delaware, Newark, Del.; Paul Sufka, M.D., assistant residency director, internal medicine residency program, University of Minnesota, Minneapolis, and member, communications and marketing committee, American College of Rheumatology; Oct. 20, 2018 presentation, American College of Rheumatology annual meeting, Chicago

Secondhand Smoke Exposure as Kids Tied to Women’s Arthritis

Secondhand Smoke Exposure as Kids Tied to Women’s Arthritis

Women who were regularly exposed to secondhand smoke as children might be at slightly increased risk of rheumatoid arthritis, a new study hints.

Rheumatoid arthritis is an autoimmune disease in which the immune system mistakenly attacks the lining of the joints. Researchers believe that a mix of genes and certain environmental factors conspire to cause the disease. And a number of studies have linked smoking to a heightened risk of RA.

The new study, published Aug. 14 in the journal Rheumatology, looked at whether childhood exposure to secondhand smoke might be a risk factor for RA, too.

The answer, researchers found, is “maybe.”

Among more than 71,000 French women followed for two decades, those exposed to secondhand smoke as kids were at somewhat higher risk of rheumatoid arthritis, versus other women. That was true of women who currently smoked, and those who’d never smoked.

But those differences were not quite significant in statistical terms. That means the association between secondhand smoke and RA risk could be a chance finding.

So while the results are “provocative,” further research is necessary, one U.S. expert said.

“It’s hard to definitively say from the data what role secondhand smoke exposure in childhood plays in RA development,” said Dr. Tamar Rubinstein, a pediatric rheumatologist at Children’s Hospital at Montefiore in New York City.

Rubinstein, who is also a member of the American College of Rheumatology, was not involved in the study.

She called the findings “interesting,” and noted that there is a “growing” body of research finding links between childhood health and environmental exposures and the risks of disease later in life.

Plus, Rubinstein said, it’s biologically plausible that secondhand smoke exposure in childhood could contribute to rheumatoid arthritis later in life.

As the study authors explain it, secondhand smoke may affect immune system development in a way that makes RA more likely to develop — particularly in kids who are genetically susceptible to the arthritic disease.

Future studies should look at whether the relationship between RA and childhood smoke exposure is stronger in people who carry RA-linked genes, according to lead researcher Dr. Marie-Christine Boutron-Ruault, from the Gustave Roussy Institute in Villejuif, France.

For now, the findings “highlight the importance of children — especially those with a family history of this form of arthritis — avoiding secondhand smoke,” Boutron-Ruault said in a news release from the journal.

The findings are based on 71,248 middle-aged women who were followed for over 20 years. During that time, 371 women were diagnosed with rheumatoid arthritis.

In line with past studies, smokers showed a higher RA risk. Women who had ever smoked, but had no childhood exposure to secondhand smoke, were 38 percent more likely to develop RA than lifelong nonsmokers.

The risk appeared somewhat higher among smokers who were regularly exposed to tobacco smoke as kids. They were 67 percent more likely to develop RA than nonsmokers were.

However, the difference between smokers who were or were not exposed to smoking as kids was not statistically significant.

There was a similar pattern among women who’d never smoked: If they were regularly exposed to smokers as children, their risk of RA was 43 percent higher.

But again, that finding was just shy of statistical significance. And only an association was seen, not a cause-and-effect link.

“That doesn’t mean that there isn’t an association in reality,” Rubinstein said. “But it suggests we need to study this further to better understand it.”

More information

The American College of Rheumatology has more on rheumatoid arthritis.

SOURCES: Tamar Rubinstein, M.D., assistant professor, pediatric rheumatology, Children’s Hospital at Montefiore, New York City; Aug. 14, 2018, Rheumatology, online

Health Tip: Risk Factors for Male Osteoporosis

Health Tip: Risk Factors for Male Osteoporosis

While people typically associate osteoporosis with women, men aren’t immune.

Osteoporosis commonly leads to weakening of the skeleton and fractures. According to the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases, by the age of 70, men and women are losing bone mass at about the same rate.

The institute mentions these factors that raise a man’s chances of developing osteoporosis:

  • Having a chronic disease affecting the kidneys, lungs, stomach or intestines.
  • Taking certain medications regularly.
  • Having low testosterone.
  • Smoking, drinking alcohol excessively, getting insufficient calcium or failing to get enough exercise.
  • Getting older.