It’s long been conventional wisdom that weather makes arthritis pain worse.
The issue has been studied through the years, with conflicting findings. But three recent studies found weather does have some impact, said Dr. Robert Shmerling, writing for the Harvard Health Blog.
In one study with 222 participants who had arthritis of the hip, researchers from The Netherlands found that patients reported slightly worse pain and stiffness as barometric pressure and humidity rose, but the weather effect was small.
Another study looked at weather-related symptoms among 800 European adults with arthritis of the hip, knee or hands. They reported increasing pain and stiffness with higher humidity, especially in cold weather. In general, changes in weather didn’t affect their symptoms, though.
Participants of a third study reported their chronic pain symptoms. Most of the 2,600 individuals had some type of arthritis. This study found “modest relationships” between pain and higher humidity, lower atmospheric pressure and higher wind speed.
Past studies have looked at the impact of rain, humidity and rising or falling barometric pressure. Humidity, temperature, precipitation and barometric pressure may all be involved, Shmerling said.
“Having reviewed the studies, I find myself not knowing how to answer my patients who ask me why their symptoms reliably worsen when the weather is damp or rain is coming, or when some other weather event happens,” Shmerling said in a Harvard Health news release. “I usually tell them that, first, I believe there is a connection between weather and joint symptoms, and second, researchers have been unable to figure out just what matters most about the weather and arthritis symptoms or why there should be a connection.”
Whether it’s helpful to know the impact of weather is also not clear. The new studies will probably not have an impact on individual arthritis sufferers until weather or internal environments can be precisely controlled.
Still, identifying a link may help with understanding the causes and mechanisms of arthritis symptoms, which could lead to better treatments or preventive strategies, Shmerling said.
“In addition, figuring out why some people seem to feel worse in certain circumstances while others notice no change [or even feel better] in those same environments could help us understand subtle differences between types of arthritis or the ways individuals respond to them,” he said.
The U.S. Centers for Disease Control and Prevention has more on arthritis.
SOURCE: Harvard Health Blog, news release, June 22, 2020
It may look like bad news, but a new study says it’s not: The number of people younger than 21 who had total hip replacement surgery in the United States jumped from 347 in 2000 to 551 in 2016.
The increase wasn’t due to a rise in the number of children with inflammatory arthritis, which often prompts a hip replacement in the very young. That suggests that non-surgical treatments to control that painful condition are effective, said senior study author Dr. Bella Mehta, a rheumatologist at the Hospital for Special Surgery in New York City.
For the study, the researchers analyzed data on total hip replacement in U.S. patients younger than 21 from about 4,200 hospitals in 46 states. The mean age of patients was 17.
Osteonecrosis (the death of bone cells due to lack of blood supply), osteoarthritis and juvenile idiopathic arthritis (JIA)/inflammatory arthritis were the most common reasons for total hip replacement.
Over the study period, total hip replacement for osteonecrosis rose from 24% to 38% of patients, but it fell from 27% to 4% for arthritis, likely due to recent improvements in drug treatments for arthritis, according to the study.
The findings were scheduled for presentation Tuesday at the American College of Rheumatology annual meeting and recently published in The Journal of Arthroplasty.
“Our study shows that although THA [total hip arthroplasty] procedures are increasingly being performed in young people, we aren’t seeing more of these patients seeking surgery for inflammatory arthritis,” Mehta said in a hospital news release.
“We’re doing a better job at treating these individuals so they don’t develop end-stage joint damage,” Mehta added. “Twenty years ago, we didn’t have access to effective pharmacologic treatments for these conditions, and now we’re using them well and helping these patients live a better life.”
Improvements in implant technology and materials have also made them far more durable than they were 20 years ago, so surgeons now feel more comfortable offering hip replacement surgery to young patients because their implants are likely to hold up under the wear and tear of decades of activity, noted study co-author Dr. Mark Figgie, chief emeritus of the surgical arthritis service at the hospital.
Mehta said the findings could be of value both to clinicians and young patients.
“I would use these results to say to a young person: ‘There are a lot of people who get these procedures; you’re not alone,'” Mehta said. “I find that, especially for young patients, knowing they’re not the only ones to experience something really helps. And it’s a life-changing procedure for them.”
Arthritis isn’t the only cause of hip pain. Find out which condition may be causing your discomfort — and how to treat it.
Hip pain doesn’t only affect older adults — stiffness and pain in this joint can strike younger people, too. Although osteoarthritis ranks high on the list of causes of hip pain, the discomfort can result from overuse or injuries at any age.
In most cases, the pain radiates from the side of the hip or groin. It can also be felt in the buttocks. The pain may worsen when you stand, walk, sit for long periods, or twist the hips. If your pain persists, see an orthopedist for a correct diagnosis and treatment.
What Causes Hip Pain?
To determine the exact cause of your hip pain, your doctor will analyze your movements, review your symptoms, and order imaging tests, such as an X-ray or MRI. Those details should provide a picture of what’s happening in your hip.
Common causes of hip pain include:
Osteoarthritis. When the cartilage cushioning the hip joint wears down, it can lead to pain and stiffness. Mostly the result of advanced age, osteoarthritis may also be due to a fracture or infection of the hip joint.
Bursitis. The bursae, or the fluid-sacs between the bones and soft tissue of the hip joint, sometimes become inflamed when the hip is stressed from overuse. That’s why bursitis is especially common among runners.
Labral Hip Tear.The hip joint is formed by the femur (the ball) and the pelvic acetabulum (the socket). A ring of cartilage — the acetabular labrum — surrounds the joint. An injury or a malformed hip (known as hip dysplasia) may cause the femoral head to grind against the acetabulum, eventually rupturing the labrum.
Hip Impingement. A hip impingement develops when the bones of the hip joint rub against each other, causing significant pain. The most likely cause is an ill-fit between the ball and socket of the hip joint, which can also lead to cartilage damage.
Fracture.As we age, our bones weaken and become more susceptible to fracture. If you fall and feel sharp, sudden pain, seek immediate medical attention. A blood clot in the leg can form following a hip fracture, which makes it especially important to act fast.
Osteonecrosis. Osteonecrosis, or avascular necrosis, is a breakdown of the hip bone because blood fails to penetrate the bones. Over time, the cartilage and bones wear away, leading to severe bone loss. In most cases, a definitive cause is not determined, although joint trauma, excessive steroid use, and certain cancer treatments may put a person at greater risk.
Snapping Hip Syndrome. Another rare condition, snapping hip syndrome, is characterized by a snapping sound or feeling in the hip, particularly when you walk or rise from a chair. Dancers and athletes are prone to this condition, which is usually painless.
Treatment for Hip Pain
Once you’ve been diagnosed, your doctor will recommend a treatment plan, which can range from conservative therapy to surgery. If the pain is due to overuse, a few days of rest can heal the strained joint or tendon. For arthritis, pain medication and physical therapy can help heal the pain and encourage freedom of movement.
Some conditions, however, may require surgery. If a labrum tear or impingement doesn’t respond to conservative treatments like physical therapy, arthroscopic surgery can repair the damaged cartilage. Therapies for bursitis typically involve physical therapy and anti-inflammatory medications. In severe cases of bursitis, surgery may be an option to drain the bursa or remove it altogether.
If the damage to the hip is substantial, either due to advanced arthritis or a fracture, hip replacement surgery is available. After surgery, intensive physical therapy will be needed to get you acclimated to your new joint.
If your hip pain doesn’t fade in a couple of days, it’s time to see a specialist at CompOrtho. Using the latest technology, we’ll diagnose your condition and recommend a customized treatment plan. Contact us today for a consultation.
MONDAY, Oct. 26, 2020 (HealthDay News) — People who have total joint replacement, or total joint arthroplasty (TJA), experience fewer falls than those who don’t undergo the surgery, a new study finds.
“Osteoarthritis (OA) is the degeneration of the cartilage in our joints over the years,” said lead author Dr. Ran Schwarzkopf, an orthopedic surgeon at NYU Langone Health in New York City. “As the wear and tear increases, patients lose their range of motion. They cannot turn their toes as easily, flex their hips or lift their legs high enough to avoid obstacles due to physical limitations as well as pain, resulting in falls and fragility fractures.”
TJA is surgery to restore function — typically by replacing a damaged joint with an artificial one.
For the study, recently published in the Journal of the American Academy of Orthopaedic Surgeons, Schwarzkopf and his team used a New York database on nearly 500,000 OA patients. Patients had either total hip or total knee replacements, and their fall rates were compared to those who didn’t have the surgeries.
“Those who had TJA fell far less than those who did not,” Schwarzkopf said in a journal news release. “From that, we concluded that TJA for patients that have OA is protective against future falls.”
TJA decreases pain, increases range of motion and agility and leads to more successful physical therapy. Mentally, patients also have less fear of falling, leading to more stability and confidence, according to the researchers.
“TJA will allow patients to go back to the daily activities they may have avoided due to pain and restricted range of motion,” Schwarzkopf said. “They are able to go back to the point in their lives when they can do activities, such as hiking, riding a bicycle or even walking their dog, without having to think about whether it will cause them physical pain or rely as heavily on ambulatory aids and caregivers.”
Not everyone needs joint replacement surgery, however. OA can be treated with anti-inflammatory drugs, walking aids and exercises to increase strength, Schwarzkopf said. Only if patients are unable to live with the symptoms is surgery recommended.
Schwarzkopf offered these safety tips to help prevent falls:
Cover sharp corners of tables or counters.
Remove loose rugs.
Install handrails in bathrooms and near staircases.
Install motion-activated night lights.
Encourage use of wearable or portable communication devices.
THURSDAY, July 9, 2020 (HealthDay News) — If you have a bad hip and lower back pain, a new study suggests that hip replacement surgery may solve both issues at once.
Researchers at the Hospital for Special Surgery in New York City focused on 500 patients who underwent hip replacement surgery and followed up with them one year after the operation.
Over 40% reported pain in their lower back prior to hip surgery. Of that group, 82% saw their back pain vanish after surgery.
It was “completely gone,” said study author Dr. Jonathan Vigdorchik, a hip and knee surgeon at the hospital.
He said that experts in his field have studied the connection between the hip and back for years.
A hip replacement is a surgical procedure to replace a worn-out or damaged hip joint with an artificial one. On average, it is a highly successful operation, with 95% of patients experiencing pain relief, according to the Hospital for Special Surgery.
“It’s an outstanding procedure,” said Dr. Craig Della Valle, a professor of orthopedic surgery at Rush University Medical Center in Chicago. “There are very few things in medicine that are close to hip replacement in terms of how good of a medical procedure it is.” He wasn’t part of the study.
But Vigdorchik added that patients who have undergone some types of spinal surgery before a hip replacement face five times the rate of complications compared to the general population — for which the complication rate is less than 1%.
This knowledge prompted him to dive deeper into the hip-back interplay.
“We noticed that there are certain conditions where a hip condition can actually put undue stress on the back,” Vigdorchik explained.
He and his fellow researchers wanted to find out how effective a hip replacement can be in eliminating low back pain, and determine which patients are more likely to benefit.
The patients whose low back pain resolved after the surgery were those with “flexible spines,” according to Vigdorchik. When a person’s spine is flexible, a stiff or poorly functioning hip can drive the spine to move more than usual, causing pain.
Those with normal flexibility in their spine were also highly likely to have their pain resolved.
“Those are the patients whose back pain went away completely after their hip replacement, because their back pain was probably caused by their hip not functioning properly to begin with,” said Vigdorchik.
But the back pain in patients with stiff spines did not go away. Patients with stiff spines already have serious arthritis of the spine, and replacing the hip is unlikely to relieve their pain.
But how can you know if your back pain could be resolved with a hip replacement?
It’s not easy to figure that out on your own, according to Vigdorchik. “It really relies on a good physical exam, and then good X-rays,” he said.
Before a patient undergoes a hip replacement, surgeons will typically take an X-ray of the patient lying down.
In this study, researchers took X-rays of their patients standing up and sitting down, both before and after the surgery.
These X-rays allowed them to see how the hip and spine moved in relation to each other, and assessed the flexibility of their spine, as the patient switched from a standing position to a seated position.
Vigdorchik encouraged other surgeons to utilize these X-rays to identify patients whose ailing backs may be relieved by a hip replacement.
He also advised surgeons in the field to “look beyond just the hip.”
“Anytime they’re looking at the hip, they should also look at the back, and anytime they’re looking at the knee, they should also look at the hip,” Vigdorchik said.
The existence of an interplay between the hip and back is well known to experts, but Della Valle said that this study showed how consistent it is.
He said the study gives surgeons in the field “some tools to try to predict which patients you can tell, ‘Yeah, your back pain will get better,’ and others, well, maybe it won’t.”
The study was published online recently during a virtual meeting of the American Academy of Orthopaedic Surgeons.
SOURCES: Jonathan Vigdorchik, M.D., orthopedic surgeon, hip and knee replacement, Hospital for Special Surgery, New York City; Craig Della Valle, M.D., professor, orthopedic surgery, Rush University Medical Center, Chicago; AAOS 2020 Virtual Education Experience, March 26, 2020, online
FRIDAY, Oct. 25, 2019 (HealthDay News) — Older women who get even light exercise, like a daily walk, may lower their risk of suffering a broken hip, a large study suggests.
A number of studies have linked regular exercise to a lower risk of hip fracture — a potentially disabling or even fatal injury for older adults. Each year, more than 300,000 people in the United States aged 65 or older are hospitalized for a broken hip, according to the U.S. Centers for Disease Control and Prevention.
The new study, of more than 77,000 older U.S. women, took a deeper look at the types of exercise that are related to the risk of hip fracture and other bone breaks.
The researchers found that, on average, women who regularly exercised at any intensity — from walking, to doing yard work, to jogging — had a lower risk of hip fracture over 14 years, compared to inactive women.
It all suggests that even light activity is enough to curb the risk of these serious injuries, said study leader Michael LaMonte, a research associate professor at the State University of New York at Buffalo.
“We were happy to see a strong relationship between walking and lower hip fracture risk,” he said. “As we get older, we naturally do less-strenuous physical activity. This suggests that to lower your risk of hip fracture, you don’t need to do anything fancy. It can be as simple as walking.”
The findings “strongly support” longstanding recommendations for people to fit physical activity into their daily routine, according to Dr. Richard Bockman.
“Get out there and walk,” said Bockman, chief of the endocrine service at the Hospital for Special Surgery, in New York City.
Lower-impact activities do not have a big effect on bone density. But Bockman, who was not involved in the study, said that while bone density matters in hip fracture risk, other factors are also involved. They include muscle strength in the lower body, balance and agility, since broken hips are almost always the result of a fall.
The findings, published online Oct. 25 in JAMA Network Open, come from the Women’s Health Initiative — a study begun in the 1990s at 40 U.S. medical centers. It involved more than 77,000 women who were between the ages of 50 and 79 when they enrolled.
At the outset, the women reported on their usual physical activities, among other lifestyle factors.
Over an average of 14 years, one-third of the women suffered a bone fracture. When it came to hip fractures, women who’d reported higher amounts of physical activity at the study’s start typically had a lower risk.
For example, women who regularly got moderate to vigorous exercise, such as brisk walking or jogging, had a 12% lower risk of hip fracture than those who were less active. But there was also a link between “mild activity” — like slow dancing, bowling or golfing — and lower hip fracture risk. And the more often women walked, at any speed, the lower their risk of a broken hip.
The news wasn’t all good: Women who exercised at moderate to vigorous intensities had a relatively higher risk of a wrist or forearm fracture, compared to less-active women.
It’s not clear why, but LaMonte offered a guess: When women with more “functional ability” do fall, they may be more likely to stretch out an arm to break the fall, which is how wrist and forearm fractures often happen.
One question the study cannot address, LaMonte said, is whether starting exercise at an older age reduces hip fracture risk. Study participants who were physically active may have been active their whole lives.
But, he said, it is clear that “sitting less and moving more” is key in older adults’ overall health, with benefits such as better control of blood pressure and diabetes, and a lower risk of heart disease.
Besides exercise, older adults can take other steps to reduce their hip fracture risk, LaMonte noted. They include getting bone mass measurements as recommended by your doctor, and following a healthy diet with adequate amounts of calcium and vitamin D.
SOURCES: Michael LaMonte, Ph.D., M.P.H., research associate professor of epidemiology and environmental health, State University of New York at Buffalo; Richard Bockman, M.D., Ph.D., chief of endocrine service, Hospital for Special Surgery, and professor of medicine, Weill Cornell Medical College, New York City; Oct. 25, 2019, JAMA Network Open, online