Signs of Rheumatoid Arthritis Can Show Up Long Before Diagnosis

Signs of Rheumatoid Arthritis Can Show Up Long Before Diagnosis

FRIDAY, May 10, 2019 (HealthDay News) — Difficulties with daily activities such as dressing, walking and eating can be seen in rheumatoid arthritis patients a year or two before they’re diagnosed, a new study shows.

“This is a new finding, and a finding that is quite intriguing,” said lead author Dr. Elena Myasoedova, a rheumatologist at the Mayo Clinic in Rochester, Minn.

“It may reflect an accumulation of symptoms between the time of first onset and the time required for providers to actually diagnose patients,” she said in a Mayo news release.

The study also found that chronic increased levels of difficulty with daily activities (functional disability) continued even after patients were diagnosed with rheumatoid arthritis and began treatment.

That may be due to a number of factors, including increasing physical and mental pain, use of treatments such as glucocorticoids and antidepressants, and anticipation of relief from symptoms, she added.

For the study, the researchers looked at 586 rheumatoid arthritis patients and 531 people without the disease in the Rochester Epidemiology Project database of medical records.

The rate of functional disability was more than two times higher among rheumatoid arthritis patients than in those without rheumatoid arthritis. In most age groups, rheumatoid arthritis patients had a 15% or higher rate of functional disability than those without the disease.

The findings show the importance of early treatment for rheumatoid arthritis patients, according to Myasoedova.

“Alerting your health care provider to difficulties in daily living can assure that patients receive the help they need,” she said.

About 1.5 million Americans have been diagnosed with rheumatoid arthritis, an autoimmune disease that most often affects the joints but can also impact other parts of the body. Rheumatoid arthritis is one of the most common chronic conditions associated with functional disability in the United States, and has a significant impact on well-being and quality of life.

Symptoms can include joint pain or swelling, but 40% of patients have symptoms that don’t involve the joints, such as fatigue, fever and loss of appetite.

The study will be published in June in the journal Mayo Clinic Proceedings.

More information

The American Academy of Family Physicians has more on rheumatoid arthritis.

SOURCE: Mayo Clinic, news release, May 1, 2019Copyright ©2017 HealthDay. All rights reserved.

1 in 4 American Workers Struggles With Back Pain

1 in 4 American Workers Struggles With Back Pain

MONDAY, May 13, 2019 (HealthDay News) — If your back aches while on the job, you have plenty of company: New research shows that nearly 40 million American workers suffer from chronic lower back pain.

In all, that’s more than a quarter of the workforce reporting lower back pain severe enough to affect their ability to work. As striking as these findings are, the researchers believe that many more workers suffer from lower back pain than the study captured.

“A lot of the cases of back pain have been attributed to work, but most workers haven’t even discussed with their doctor whether it might be related to work,” said lead author Dr. Sara Luckhaupt, a medical officer at the U.S. National Institute for Occupational Safety and Health.

In addition, many workers miss work because of the pain or change jobs because of it, she said.

Luckhaupt said that both men and women reported suffering from lower back pain. Sufferers were more likely to be 45 to 64. Obesity can also contribute to lower back pain, she added.

The greatest number of workers with lower back pain worked in construction, building maintenance and grounds cleaning, Luckhaupt said, “so, jobs that require a lot of manual labor.”

In addition, people whose jobs requires lifting, pulling or standing reported more lower back pain, Luckhaupt said.

One specialist said it’s difficult to determine if someone’s lower back pain is really work-related.

“Work environment can worsen back pain, but often it’s difficult to assign causative factors to the back pain in the absence of a specific incident,” said Dr. Qusai Hammouri, an orthopedic surgeon at Staten Island University Hospital in New York City.

“So, it’s difficult to say if work caused your back pain, or you had back pain and then it got worse as you worked more,” said Hammouri, who wasn’t involved with the research.

For the study, Luckhaupt and her colleagues surveyed more than 19,000 adults in 2015. The participants were asked whether they had lower back pain and if it was work-related, and whether their pain affected their work.

More than a quarter of those surveyed (26%) said they suffered from lower back pain. Extrapolating the data, the researchers determined that represents nearly 40 million workers.

The report was published online May 13 in the Annals of Internal Medicine.

Another expert not part of the study says back pain can be made worse by repeat motions.

“Pain in the back in working-age adults who are otherwise well occurs without a violent precipitant and is exacerbated by motion of the low back,” said Dr. Nortin Hadler, an emeritus professor of medicine and microbiology and immunology at the University of North Carolina, Chapel Hill.

Hadler added that this kind of pain is not necessarily work-related. “It can start in workers when not at work and persists outside work,” he said.

For example, it can be difficult to lift a package, whether in the warehouse, or “in the crib [such as a baby] — where the ‘package’ has no handles and squirms,” Hadler said.

Luckhaupt said that treating lower back pain often involves several kinds of treatment, including physical therapy and painkillers.

She added that often pain can be controlled with nonopioid painkillers.

“Most importantly, workers with back pain should talk with their employers to see if there are things that they can do to make the work healthier,” Luckhaupt said.

More information

Visit the U.S. Centers for Disease Control and Prevention for more on back pain in the workplace.

SOURCES: Sara Luckhaupt, M.D., M.P.H., medical officer, U.S. National Institute for Occupational Safety and Health, U.S. Centers for Disease Control and Prevention, Cincinnati; Nortin Hadler, M.D., emeritus professor, medicine and microbiology/immunology, University of North Carolina, Chapel Hill; Qusai Hammouri, M.D., orthopedic surgeon, Staten Island University Hospital, New York City; May 13, 2019, Annals of Internal Medicine, onlineCopyright ©2017 HealthDay. All rights reserved.

After a Stroke, Your Bones Need Care

After a Stroke, Your Bones Need Care

THURSDAY, April 25, 2019 (HealthDay News) — Stroke survivors often face limited mobility, which quadruples their odds of osteoporosis, broken bones and falls. But most are never screened for these problems, new research reveals.

“Our study adds to previous research that found despite an increased risk, only a small number of people who have recently had a stroke are tested and treated for osteoporosis,” said lead author Dr. Moira Kapral. She is director of general internal medicine at the University of Toronto.

Impaired mobility can result in bone mineral density decline, which is associated with osteoporosis. The condition weakens bones and increases risk of fractures.

In this study, researchers looked at more than 16,500 Canadian stroke survivors, aged 65 and older, from Ontario. Of these patients, only 5% had undergone bone mineral density testing; 15.5% had been prescribed medications for osteoporosis within the year after their stroke, and only a small percentage were prescribed medications for osteoporosis for the first time.

Patients most likely to have bone mineral density testing tended to be younger, female and to have had low-trauma fractures in the year after their stroke.

Patients were more likely to be prescribed medications for osteoporosis after their stroke if they were female, already had the bone-thinning disease, had previously broken bones, had previous bone mineral density testing, or had fallen or broke bones after their stroke.

The study was published April 25 in the journal Stroke.

“This study offers more evidence that there is a missed opportunity to identify people with stroke at increased risk of fractures, and to initiate treatment to prevent bone loss and fractures,” Kapral said in a journal news release.

Less than one-third of older U.S. women are screened for osteoporosis. The maximum treatment rate for some high-risk patients is about 30%, the researchers pointed out.

More information

The U.S. Office on Women’s Health has more about osteoporosis.

SOURCE: Stroke, news release, April 25, 2019

Copyright ©2017 HealthDay. All rights reserved.
Step-by-Step Exercises for a Stronger Back

Step-by-Step Exercises for a Stronger Back

THURSDAY, April 11, 2019 (HealthDay News) — Are you neglecting or even unaware of the muscles in your back? If so, you’re putting yourself at risk.

The trapezius is the diamond-shaped muscle that runs from neck to middle back and from shoulder to shoulder across the back. The latissimus dorsi — or “lats” — are the large back muscles that run from either side of the spine to your waist.

Here are two strength-training exercises that will help you develop these muscles for better upper body fitness.

Important: Start with a weight that allows you to complete at least eight reps with proper form, perhaps as low as 2-pound dumbbells. Build up to 10 to 15 reps for one complete set, and progress from one to three complete sets before increasing the weight. Never jerk the weights — controlled, steady movement is what brings results.

Standing dumbbell rows target the trapezius muscles as well as the upper arms and shoulders. Stand straight, feet shoulder-width apart, with a weight in each hand. Your elbows should be slightly bent, the dumbbells touching the fronts of your thighs, palms facing your body. As you exhale, use a slow, controlled movement to lift the weights straight up by bending the elbows up and out to bring the weights to shoulder level. Hold for a second, then inhale as you lower your arms to the starting position. Repeat.

Bent-over one-arm rows target the lats as well as the upper arms and shoulders. To work the right side first, stand to the right side of a bench. Place your left knee and left hand on it for support. Your back should be nearly parallel to the floor. Hold a dumbbell in your right hand, palm facing inward. Using only your upper arm, bend at the elbow to lift the dumbbell straight up to your waist as you exhale. Hold for a second and then lower it with control as you inhale. Complete reps, then switch sides and repeat.

You can also do bent-over rows using both arms at once. Stand with feet about shoulder-width apart. Hold a dumbbell in each hand and, bending from the waist, bring your back to nearly parallel with the floor. Keeping arms close to your sides, bend the elbows to lift the weights, bringing them up to waist level. Hold for a second and then lower the weights with control as you inhale. Repeat.

More information

The American Council on Exercise has more on exercises targeting the back muscles.

Copyright ©2017 HealthDay. All rights reserved.
One-Third of U.S. Kids Have Back Pain, Study Says

One-Third of U.S. Kids Have Back Pain, Study Says

TUESDAY, March 12, 2019 (HealthDay News) — As American kids pack on the pounds, the number of those with back pain is on the rise.

One in three between the ages of 10 and 18 said they had backaches in the past year, according to a survey of about 3,700 youngsters. The incidence rose along with kids’ age and weight and was higher among those who play competitive sports.

Though many people probably associate back pain with older people, the orthopedic surgeon who led the study was not surprised by his findings.

“We see a lot of kids who have pain from overuse injuries or joint pain from playing sports,” said Dr. Peter Fabricant, who treats pediatric patients at the Hospital for Special Surgery in New York City. “Of these kids who had back pain, very few actually required any sort of medical intervention. Most didn’t need treatment at all.”

About 80 percent of adults suffer from lower back pain at some time, according to the U.S. National Institutes of Health.

But this is the first time the extent of back pain among children has been estimated on nationwide scale, the authors said. The youngsters surveyed were equally split by age and gender.

On average, those who reported back pain weighed more and had higher body mass indexes, or BMIs. (BMI is a measure of body fat based on height and weight.)

Back pain was more common among girls than boys (38 percent to 29 percent). And the percentage reporting back pain rose about 4 percent with each year of increasing age, according to the authors. Most often, pain affected the lower back.

Nearly half said they hurt in the evenings and more than 15 percent said back pain interrupted their sleep. Only 41 percent sought treatment, and most who did had physical therapy.

Participation in competitive sports was strongly linked to back pain, with junior varsity and varsity athletes experiencing it more often than younger or recreational players. Most survey participants were active, with basketball the most commonly played sport, followed by dance, baseball, football and soccer.

Another contributor to kids’ back pain is the backpacks they use to tote their stuff, researchers said. Those who used one strap to carry their packs reported significantly more back pain than did those who used both straps.

Those who used rolling backpacks reported back pain the most often. Fabricant said it wasn’t clear whether pain prompted their use of the rolling packs or whether the rolling packs contributed to their pain.

While long-term pain prospects are unclear, Fabricant said “it would certainly stand to reason” that kids who experience backaches would be more likely to do so as adults.

Dr. Henock Wolde-Semait is a pediatric orthopedist at NYU Winthrop Hospital in Mineola, N.Y., who reviewed the findings. He said the results mirror what he sees in his own practice.

“Lots of kids have back pain for various reasons. It seems like it’s on the rise,” he said.

“The majority of them do well [without surgical treatment], which is why in the past this may have been overlooked or taken for granted,” Wolde-Semait added.

Fabricant suggested parents urge their kids to avoid any sport or activity related to their back pain. Physical therapy may help by stretching and strengthening key muscles, he said, and it’s wise to avoid carrying backpacks on only one shoulder.

Wolde-Semait said excessive screen time may also play a role in kids’ back pain. He said youngsters should seek “moderation in every aspect.”

The study is to be presented March 12 at the American Academy of Orthopaedic Surgeons’ annual meeting, in Las Vegas. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

More information

Harvard Health offers tips for a pain-free back.

SOURCES: Peter Fabricant, M.D., M.P.H., pediatric orthopedic surgeon, Hospital for Special Surgery, New York, N.Y.; Henock Wolde-Semait, M.D., pediatric orthopedist, NYU Winthrop Hospital, Mineola, N.Y.; presentation, American Academy of Orthopaedic Surgeons annual meeting, Las Vegas, March 12, 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.
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