- Managing the Pain of Osteoarthritis Day by Day Learn simple ways to help you cope with osteoarthritis pain and feel better day by day.
- Your 6-Week Walking Plan Your 6-week walking plan for arthritis relief.
- Coping With Arthritis Day by Day Coping strategies for living with osteoarthritis and managing pain.
- Ask Your Doctor About Arthritis Don't suffer in silence. Ask your doctor these 10 questions.
- Drop 10 & Improve Arthritis Pain Learn how losing just 10 pounds can help relieve pain and make you feel better.
- Understanding Osteoarthritis What happens when you have osteoarthritis? Get the facts here.
It makes perfect sense if you think about it: carting around extra weight in your middle, for example, places a burden on your knees and hips. And study after study shows that this extra stress can put you at risk for developing osteoarthritis (OA), the wear-and-tear form of the disease. Being overweight or obese will also amplify your pain and make it harder for you to remain active and independent if you've already got OA.
With obesity rates soaring, it's no wonder that 27 million Americans now have OA, according to the Arthritis Foundation. But modest weight loss -- dropping just 10 to 15 pounds -- can make a huge difference in your knee and hip OA pain, and may even postpone or prevent joint replacement surgery.
As of now, there are no medications that can help modify or stop the OA disease process once it has started, so weight loss and exercise have become increasingly important.
"Being overweight puts too much pressure on the joint, and stresses the tendons and a number of other structures around the joint like your muscle," explains Emilio B. Gonzalez, MD, chief of rheumatology at University of Texas Medical Branch in Galveston. "Overweight people usually develop accelerated osteoarthritis in their weight-bearing joints like hips and knees, so one of the treatment strategies is to lose weight."
Weight Loss and OA: Any loss Will Do
"Any weight loss can make a difference in pain control and delaying the progression of the condition," Gonzalez says. "In some cases, we can prevent the need for surgery, but this depends on how advanced the OA is."
Many orthopaedic surgeons won't even do the surgeries if you are overweight,
so there is really no way to feel better without first slimming down, he says.
Being overweight increases the risk of any surgery, including joint
His prescription? "Lose weight if you can, and exercise a little bit," he
suggests. "The best exercise is aquatic because your body floats and there is
no extra pressure placed on the joints and muscles."
Walking can also aid weight loss efforts. "The best surface to walk on is grass or a softer surface because pounding on concrete can increase tendon damage," Gonzalez says.
"If you achieve significant weight loss, you will get symptomatic relief," says Michael Parks, MD, an assistant attending orthopaedic surgeon at the Hospital for Special Surgery in New York City."There is no hard and fast number," Parks says. "It varies from patient to patient."
"If you decrease your body size, the load on your knees will go down," agrees Laura Thorp, PhD, an OA researcher at Rush University Medical center in Chicago. Higher than normal knee loads are characteristic of knee OA and progression, she explains. A study in Arthritis & Rheumatism showed that losing just 1 pound resulted in a fourfold reduction in knee joint load among overweight and obese people with knee osteoarthritis.
Weight Loss and OA: What Are You Waiting For?
But if losing weight were really so easy, wouldn't more people do it?
Yes, says David Felson, MD, a professor of medicine and public health at Boston University School of Medicine. "If we could only get people to adhere to weight loss and exercise regimens, we could forestall and even prevent the need for total knee replacement," he says. "Weight loss and exercise are the initial therapies for OA and the thing we speak to everyone about."
The trick is to set people up to succeed, not fail, he says.
"I usually tell my OA patients to lose 10 to 15 pounds," Felson says. "I do not want to create an impossible goal because unless they have bariatric surgery, losing 50 pounds is probably not reasonable."
"I say, 'look, let's keep this reasonable: how can we help you lose 10 to 15 pounds?'"
Being more active is just one part of the equation, he says. "I may recommend a nutritionist to help with diet, and then I will review their favorite foods and their calories and healthier substitutes with them."
Choosing whole-grain over white-bread products is a good place to start. Whole-grain products such as oatmeal and whole-wheat bread and pasta are better sources of fiber than their refined counterparts (white bread and white pasta). The more fiber a food has, the more full you feel, and the less likely you are to overeat.
Emilio B. Gonzalez, MD, chief, rheumatology, University of Texas Medical Branch, Galveston.
Michael Parks, MD, assistant attending orthopaedic surgeon, Hospital for Special Surgery, New York City.
Laura Thorp, PhD, assistant professor, anatomy and cell biology, Rush University Medical Center, Chicago.
David Felson, MD, professor, medicine and public health, Boston University School of Medicine.
Messier S.P., Arthritis & Rheumatism, 2005; vol 52: pp 2026-2032.
Arthritis Foundation web site: "OA Basics: Who is at Risk?"
Reviewed by Brunilda Nazario, MD on March 31, 2011
© 2010 WebMD, LLC. All rights reserved.
Important Safety Information About Cymbalta®
The most important information you should know about Cymbalta:
Antidepressants can increase suicidal thoughts and behaviors in children, teens, and young adults. Suicide is a known risk of depression and some other psychiatric disorders. Call your doctor right away or seek emergency help if you have new or worsening depression symptoms; unusual changes in behavior, such as agitation, irritability, impulsivity, or restlessness; or thoughts of suicide. Be especially observant within the first few months of treatment or after a change in dose. Approved only for adults 18 and over.
Cymbalta may be associated with serious side effects. Call your healthcare provider right away or seek emergency help if you experience any of the following:
- Itching, right upper-belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of life-threatening liver problems. Severe liver problems, some fatal, have been reported
- High fever, confusion, stiff muscles, muscle twitching, or racing heart rate, which may be signs of serotonin syndrome, a potentially life-threatening condition
- Abnormal bleeding, especially if Cymbalta is taken with aspirin, NSAID pain relievers (like ibuprofen or naproxen), or blood thinners
- Serious, possibly life-threatening skin reactions, which may include skin blisters, peeling rash, mouth sores, hives, or other allergic reactions
- Abnormal mood (mania), which may include greatly increased energy, severe trouble sleeping, racing thoughts, talking more or faster than usual, and reckless behavior
- Seizures or convulsions
- Decreased blood pressure upon standing, which can cause dizziness or fainting, mostly when first starting or increasing the dose. Cymbalta can also increase blood pressure. Your healthcare provider should check your blood pressure prior to and while taking Cymbalta
- Headache, weakness or feeling unsteady, confusion, problems concentrating, or memory problems, which may be signs of low sodium levels in the blood. Elderly people may be at greater risk
- Problems with urination, including decreased flow or inability to pass any urine
- Changes in appetite or weight. Children and adolescents should have height and weight monitored
Do not stop Cymbalta or change your dose without talking to your healthcare provider, as you could have side effects.
Cymbalta is not for everyone. Do not take Cymbalta if you:
- Are taking or have recently taken a monoamine oxidase inhibitor (MAOI), including the antibiotic linezolid, or Mellaril® (thioridazine). Taking Cymbalta close in time to these medicines can cause serious or even life-threatening side effects
- Have uncontrolled narrow-angle glaucoma (eye pain due to increased eye pressure)
Before taking Cymbalta, talk with your healthcare provider:
- About all your medical conditions, including
- kidney or liver problems, heart problems, or high blood pressure
- glaucoma or diabetes (Cymbalta may worsen diabetes or a type of glaucoma)
- seizures/convulsions, mania, or if you have bipolar disorder
- if you have ever had or been told you have bleeding problems, low sodium levels in your blood, or delayed stomach emptying
- About all prescription and over-the-counter medicines and supplements you take or plan to take, including
- antibiotics or medicines for migraine, mood, or psychotic disorders, to avoid a potentially life-threatening condition when taken with Cymbalta
- aspirin, NSAID pain relievers, or blood thinners, because they may increase risk for bleeding
- About your alcohol use (you should not take Cymbalta if you drink heavily)
- If you are pregnant or plan to become pregnant during therapy or are breast-feeding
Most common side effects of Cymbalta (this is not a complete list):
Nausea, dry mouth, sleepiness, fatigue, constipation, decreased appetite, increased sweating, dizziness. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Other safety information about Cymbalta:
- Cymbalta may cause sleepiness and dizziness. Until you know how Cymbalta affects you, you shouldn't drive a car or operate hazardous machinery
- People age 65 and older who took Cymbalta reported more falls, some resulting in serious injuries
How to take Cymbalta
Take Cymbalta exactly as directed by your healthcare provider. Do not open, break, or chew capsule; swallow it whole. Cymbalta is available by prescription only.
DD CON ISI 02OCT2012
©Lilly USA, LLC 2012. All rights reserved.
Cymbalta is a registered trademark of Eli Lilly and Company.
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