CHICAGO—Rheumatology healthcare providers should embrace collaborative approaches to manage chronic musculoskeletal pain in older adult patients, including models of care that involve multiple providers, patients and their caregivers. That was the message delivered by two speakers in the Interdisciplinary Management of Chronic Musculoskeletal Pain in Older Adults session at the 2018 ACR/ARHP Annual Meeting. “As…
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Insights on the Diagnosis & Treatment of Low Back & Hip Pain
CHICAGO—Two experts presented insights on the diagnosis and treatment of low back and hip pain, including a refresher course on the mechanical structures involved, in Anatomy in a Day: Demystifying Low Back Pain and Lateral Hip Pain: New Patho-Anatomical Perspectives, a session at the 2018 ACR/ARHP Annual Meeting. Low Back Pain Avoid using such terms…
Calcineurin Inhibitor Pain Syndrome: A Case Report & Literature Review
CHICAGO—Medications have frequently been implicated as a cause of musculoskeletal complaints, including persistent arthralgias, arthritis and myalgias.1 The list of offending agents is diverse, and the degree of symptoms is variable. In the world of transplant recipients, this list is exhaustive and includes immunosuppressive agents (cyclosporine, tacrolimus); myeloid growth factors, such as G-CSF; antibiotics (quinolones);…
Hip Exercises May Improve Walking, Pain with Knee Arthritis
(Reuters Health)—Patients with knee osteoarthritis (OA) can add hip-strengthening exercises to their workout to improve the ability to walk and maybe reduce pain, according to a research review. Based on pooled data from eight clinical trials with a total of 340 patients, hip strengthening exercises involving weights or elastic bands would help the most, the…
Tanezumab for OA Pain
In a recent study, tanezumab proved more effective than placebo in treating patients with moderate to severe pain caused by hip or knee osteoarthritis…
Ibuprofen an Option for Early Pain Control after Hip Replacement
NEW YORK (Reuters Health)—Combining paracetamol (acetaminophen) with ibuprofen does not cut postoperative use of morphine in a clinically meaningful way relative to ibuprofen alone, in patients undergoing total hip arthroplasty (THA), results of a Danish randomized trial suggest. “Although the combined use of paracetamol and ibuprofen reduced immediate postoperative morphine consumption compared with paracetamol alone…
How to Proceed When Kids Present with Joint Pain but Normal Exams
CHICAGO—When it comes to correctly diagnosing joint pain in children, “things take time,” said Michael L. Miller, MD, quoting Danish physicist and poet Piet Hein. Children with pain but normal physical examinations may need to return to the clinic for repeat evaluation over several months. “I often tell parents that laboratory tests may help in…
Intensive Patient Education May Not Be Helpful for Acute Low Back Pain
Education with recommended first-line care may not improve pain outcomes in patients with acute low back pain. When comparing patients who received education with those who received professional consultation without information or advice, researchers found patient education was no more effective than placebo at reducing depression or incidence of chronic low back pain…
Carla Guggenheim, DO, Dances through the Pain
Two years ago, Carla Guggenheim, DO, a rheumatologist in private practice in Lansing, Mich., was recovering from extensive shoulder surgery when her dance teacher asked her to perform a complex Indian piece from the Bharatanatyam Repertory at a gala showcasing graduate dance students. Because of her surgery, Dr. Guggenheim agreed to dance only 90 seconds…
The Perils of Pain Meds Revisited
More than 10 years ago, I wrote a commentary in The Rheumatologist, called “Perils of Pain Meds,” about the over-prescribing of opioid analgesics for common causes of chronic noncancer pain, which was a major contributor to the opioid epidemic.1 Since that time, although there has been a greater than 20% decrease in opioid prescribing, the…
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