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Coping With Chronic Pain: Physical Methods of Pain Management - 7/15/2011

 

Pain is the body's way of responding to an injury and telling you something is wrong. It’s normal for you to have pain when you are injured or ill. But pain that lasts for weeks, months or years is not normal. Pain that lasts for 3 months or longer is called chronic. Chronic pain can occur anywhere in your body. It can range from being mild and annoying to interfering with day-to-day life. The nerves that transfer the pain “message” to your brain may be triggered by a multitude of things including muscle tension, stiffness, weakness, or spasms. Feelings of frustration, anger, and fear can make the pain more intense and long lasting. For example, depression seems to increase a person's perception of pain and decrease his or her ability to effectively cope with it. Often, treating the depression treats the pain as well. No matter where or how you are experiencing chronic pain, focused treatment should be taken seriously as it is the only real way to alleviate it. Below is a list of effective physical methods to remedy chronic pain:

Heat and Ice

The easiest method of dealing with chronic pain is with heat and ice. Heat, in the form of warm showers or hot packs, can relieve chronic pain by loosening stiff muscles and relaxing joints. Cold packs or ice packs provide pain relief by numbing the pain-sensing nerves in the affected area. Cold also helps reduce swelling and inflammation. Switch back and forth, by applying heat or cold for 15 to 20 minutes at a time to the area where you feel the pain. To protect your skin, place a towel between your skin and the source of the cold or heat. Here are some simple ways to make heat and ice packs:

  • Warm towels or hot packs in the microwave for a quick source of heat. (Handle carefully.)
  • Make instant cold packs from frozen juice cans or bags of frozen vegetables or meats.
  • Freeze a plastic, re-sealable bag filled with water to make a good ice bag.
  • Try Healthy Back’s Hotties Micro Hottie, a safe and reliable alternative to the traditional ‘hot water bottle’ without the need for boiling water or tricky stoppers.
  • Cold Therapy Wraps, like the ICE Down, are designed to deliver cold compression in the simplest and most convenient manner possible.


Unfortunately, the heat and ice remedy simply masks the pain without curing it, but is an effective method for immediate treatment and when you are on-the-go.

 

Ointments and Rubs

Specialized ointments and rubs consisting of natural herbs and ingredients have been used to combat chronic pain for centuries. One of the most popular and effective ointments is Tiger Balm, which mainly treats sore muscles and over-exertion, but also alleviates chronic pain including backache, arthritis, stiffness, strains, and sprains. Developed in 1870 by Aw Chu Kin of Rangoon, Burma, Tiger Balm combines camphor, menthol, and other herbal oils to penetrate deep down into muscle tissue and increase blood circulation at the area of application, carrying away broken down cells and fluids like lactic acids which cause pain and discomfort. Tiger Balm is available at the Healthy Back Store, both online and in stores.


Spinal Supports and Braces
Supports or braces reduce pain and inflammation by restricting movement. Following a vertebral fracture, a back brace or support will relieve pain and allow you to resume normal activities while the fracture heals. However, continuous use of a back support can weaken back muscles. For this reason, exercises to strengthen the muscles in the back should be started as soon as possible.


Exercise

Prolonged inactivity causes loss of muscle mass and strength, and can leave you prone for injury. A regular exercise program and physical therapy can help you regain strength, energy, and a more positive outlook on life. Exercise relieves tension, increases flexibility, strengthens muscles, reduces fatigue, and more importantly raises the body's level of endorphins - natural painkillers produced by the brain - to relieve pain. Healthy Back offers a wide range of exercise products including the AeroPilates 700 which combines all the benefits of a studio workout with a crucial cardiovascular workout, all in your own living room! To allow you to get a proper workout the AeroPilates is low impact (gentle on your joints) and since you a lying on your back there is no concussion on your legs, hips, or spine. This exercise helps to relax the mind and rejuvenate the body so that you can overcome chronic pain.


Physical Therapy and Massage Therapy

Physical therapists teach proper posture and exercises to strengthen the back and abdominal muscles without injuring a weakened spine. Water therapy in a pool, for example, is one of the best exercise techniques for gently improving back muscle strength and reducing pain.


Massage therapy ranges from a light, slow, circular motion with the fingertips to a deep, kneading motion that moves from the center of the body outward toward the fingers or toes. Massage relieves pain, relaxes stiff muscles, and smooths out muscle knots by increasing the blood supply to the affected area and warming it. As a warning, deep muscle massage should not be done near the spine of a person who has spinal osteoporosis; light, circular massage with fingers or the palm of the hand is best in this case. Healthy Back offers massage products including various different massage chairs. The INADA Sogno Dreamwave Massage Chair a top-of-the-line high tech chair that incorporates your whole body and customizes massages for every body type. It’s massage therapy in the comfort of your own home.


To find the suggested products or search through our range of ergonomic solutions, please visit www.healthyback.com.


The Healthy Back Store is a specialty retailer that provides high-end comfort solutions and ergonomic products for back pain and other physical conditions. The company offers pain relieving products for sleeping, working, exercising and relaxing including back and neck supports, specialty mattresses, office chairs, exercise and therapy equipment, recliners and massage chairs. Healthy Back sells recognizable name brands such as Herman Miller and Tempur-Pedic, but also represents smaller, specialized manufacturers offering a growing selection of house-branded goods. Healthy Back has 23 stores in 6 states across the United States, and also sells through its website and call center, making it the largest privately owned back care retailer.

Coping With Chronic Pain - Psychological Methods of Pain Management - 7/15/2011

 

A large number of people in the United States suffer from chronic pain, pain that just won't go away. Chronic back and neck pain will last beyond the expected healing time and often interfere with daily life. Whatever the cause of chronic pain, feelings of frustration, anger and fear can make it more intense. Aside from physical treatments, there are a number of psychological methods of paint management, such as relaxation, biofeedback, and imagery that may provide relief and should be discussed with your health care professional.

 

Relaxation is one of the simplest, but rarely followed, methods of relieving bodily pain. Concentration and slow, deep breathing can release tension from muscles and relieve pain. The Healthy Back Store offers a wide selection of relaxation products including our massage chair inventory featuring brands like Inada and Human Touch. These highly sought after personal massage chairs can be assigned to target the parts of your body that need the most attention, while sending your entire body into a state of pure relaxation.

 

Other techniques like biofeedback can be taught by a health care professional who uses special machines to help you learn to control your mind and body, such as heart rate and muscle tension. As you begin to release muscle tension, the machine immediately indicates appropriately. Once the technique is mastered, it can be practiced without the use of the machine and help of the professional.

 

Muscle tension is more commonly relieved using inversion tables and inversion therapy. By using an inversion table, available at the Healthy Back Store, for just five minutes a day, you will align your body with the downward force of gravity, which will increase the space between your vertebrae, relieving pressure on the areas in your back that are in pain such as the discs, ligaments, and nerve roots.

 

There are also a number of distraction techniques that will help you focus your attention away from the pain and towards more pleasant subjects. This can be as simple as watching television, reading a book, or listening to music, but can also be practiced through imagery or hypnosis. Imagery involves concentrating on mental pictures of pleasant scenes or events to reduce pain. Hypnosis can be practiced through the use of a therapist or by learning the methods of self-hypnosis which can be utilized when pain interrupts.

 

Individual, group, or family therapy may be useful for those whose pain has not responded to physical methods. People who suffer from chronic pain often experience emotional stress and depression. Therapy can help you cope with these feelings, making it easier to manage your pain.

 

All these psychological methods of pain-relief are an excellent complimentary tool to physical Healthy Back products. Be sure to take a look at our selection of back- and neck-care products to find the perfect option for you.


 

The Healthy Back Store is a specialty retailer that provides high-end comfort solutions and ergonomic products for back pain and other physical conditions. The company offers pain relieving products for sleeping, working, exercising and relaxing including back and neck supports, specialty mattresses, office chairs, exercise and therapy equipment, recliners and massage chairs. Healthy Back sells recognizable name brands such as Herman Miller and Tempur-Pedic, but also represents smaller, specialized manufacturers offering a growing selection of house-branded goods. Healthy Back has 23 stores in 6 states across the United States, and also sells through its website and call center, making it the largest privately owned back care retailer.

Discectomy - 8/8/2011

A discectomy is a surgery to remove all or part of a herniated disc that is pressing against a nerve root or spinal cord in an effort to protect your spinal column. Spinal discs cushion your spinal bones – more commonly known as vertebrae – and when one herniates – or moves out of place – the pain can be debilitating.

Among others, herniated disc sufferers usually experience these symptoms:

  • Chronic Leg pain or numbness.
  • Weakness in muscles of your lower leg or buttocks.
  • An inability to control bowel movements or urination.


Most people who experience these symptoms do so on a controlled level, often being treated first without surgery. Anti-inflammatory medications [such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn)], physical therapy, and exercise are often first treatments. One type of physical therapy is
Inversion Table Therapy, a strange-looking but extremely effective way to relieve back pain through decompression, just what you need when a disc is herniated. For exercise, low impact cardio and aerobic workouts are recommended on a frequent basis, and can be performed in the comfort of your own home with the use of Body Sport Exercise Balls, Trampolines for light jogging, and Stepping Machines. Over time, many of the symptoms of low back pain caused by a herniated disc often improve or go away without surgery.

Occasionally, the pain is so severe that even prescription pain medicine cannot subdue it, in which case doctors recommend having surgery immediately. Since the spine carries central nerves and is used in nearly every activity we do, it is crucial not to wait and risk the condition getting worse.

Should it be necessary for a discectomy, a surgeon may perform the disk removal in one of several ways:
 

 

  • Microdiscectomy – recent scientific advances have allowed surgeons to repair herniated discs without significant direct surgery on the bones, joints, ligaments, or muscles of your spine. Thus, a microdiscectomy is done in a hospital or outpatient surgical centerand can be completed in just a few hours.
  • Discectomy - usually performed as part of a larger surgey such as a laminectomy, foraminotomy, or spinal fusion, a discectomy can be performed from your lumbar spine to cervical spine located in the neck. This type of surgery is invasive, performed at a hospital under general anesthesia, and can take weeks or months to fully heal.

 

The fortunate fact about a herniated disc is that it is largely avoidable with preventive and safe behavior, such as surrounding yourself with ergonomic furniture and accessories at home or in the office, using lumbar supports, battery powered or manual massager, a soothing muscle rub such as Tiger Balm, and a Far Infrared Back Wrap will alleviate your pain and reduce the risk for injury. It is important to know the details about a surgery as important as a Discectomy, but let us all hope that it is something we do not have to experience first hand.


HealthyBack.com is a specialty retailer that provides high-end comfort solutions and ergonomic products for back pain and other physical conditions. The company offers pain relieving products for sleeping, working, exercising and relaxing including back and neck supports, specialty mattresses, office chairs, exercise and therapy equipment, recliners and massage chairs. Healthy Back sells recognizable name brands such as Herman Miller and Tempur-Pedic, but also represents smaller, specialized manufacturers offering a growing selection of house-branded goods. Healthy Back has 23 stores in 6 states across the United States, and also sells through its website and call center, making it the largest privately owned back care retailer.

Herniated Nucleus Pulposus

The condition, herniated nucleus pulposus, is a slipped disk along the spinal cord and occurs when all or part of the soft center of a spinal disk is forced through a weakened part of the disk. Most herniation takes place in the lower back (lumbar area) of the spine. Lumbar disk herniation occurs 15 times more often than cervical (neck) disk herniation, and it is one of the most common causes of lower back pain. The cervical disks are affected 8% of the time and the upper-to-mid-back (thoracic) disks only 1 - 2% of the time.

Disk herniation occurs more frequently in middle-aged and older men, especially those involved in strenuous physical activity. Other risk factors include any congenital conditions that affect the size of the lumbar spinal canal.

A quick snapshot of the spine and its construction provides insight into how and why herniation may take place. The bones (vertebrae) of the spinal column run down the back, connecting the skull to the pelvis. These bones protect nerves that come out of the brain and travel down the back and to the entire body. The spinal vertebrae are separated by disks filled with a soft, gelatinous substance, which provide cushioning to the spinal column. These disks may herniate (move out of place) or rupture from trauma or strain.

In some instances nerve roots (large nerves that branch out from the spinal cord) may become compressed, resulting in neurological symptoms, such as sensory or motor changes.

Symptoms of a herniated lumbar disk include: muscle spasm; muscle weakness or atrophy in later stages; pain radiating to the buttocks, legs, and feet; pain made worse with coughing, straining, or laughing, severe low back pain; tingling or numbness in legs or feet.

A physical examination and history of pain may be all that is needed to diagnose a herniated disk. A neurological examination will evaluate muscle reflexes, sensation, and muscle strength. Often, examination of the spine will reveal a decrease in the spinal curvature in the affected area.

The main treatment for a herniated disk is a short period of rest with pain and anti-inflammatory medications, followed by physical therapy. Most people who follow these treatments will recover and return to their normal activities. A small number of people need to have further treatment, which may include steroid injections or surgery.

It may take several months to a year or more to resume all activities without pain or strain to the back. People with certain occupations that involve heavy lifting or back strain may find it necessary to change job activities to avoid recurrent back injury.

Spinal Fusion and What's Involved

Spinal fusion is surgery to fuse spine bones (vertebrae) that cause you to have back problems. Fusing means two bones are permanently placed together so there is no longer movement between them. Spinal fusion is usually done along with other surgical procedures of the spine.

Spinal fusion may be recommended for:

  • Treatment for spinal stenosis
  • After diskectomy in the neck
  • Injury or fractures to the bones in the spine
  • Weak or unstable spine caused by infections or tumors
  • Spondylolisthesis, a condition in which one vertebrae slips forward on top of another - Abnormal curvatures, such as those from scoliosis or kyphosis


In order to decide whether or not spinal fusion is the right option for you, it is important to understand the procedure. First, you will be asleep under general anesthesia. Your surgeon has several choices about where to make the first incision.

The surgeon may make an incision on your back or neck over the spine. Muscles and tissue are separated to expose the spine.

The surgeon may make a cut through one side of your belly (for surgery on your lower back). The surgeon will use tools called retractors to gently separate, hold the soft tissues and blood vessels apart, and have room to work.

The surgeon may make the cut on the front of the neck, toward the side.

The surgeon will use a graft (such as bone) to fuse the bones together permanently. There are several different ways of fusing vertebrae together:

  • Strips of bone graft material may be placed over the back part of the spine.
  • Bone graft material may be placed between the vertebrae
  • Special cages may be placed between the vertebrae. These cages are packed with bone graft material.


The surgeon may get the graft from another part of your body (usually around your pelvic bone). This is called an autograft. Your surgeon will make a small cut over your hip and remove some bone from the back of the rim of the pelvis. In some cases, the bone may come from an allograft, a bone bank. Finally, the surgeon may decide to use a synthetic bone substitute, but this is not common yet.

The vertebrae are often also fixed together with screws, plates, or cages. They are used to keep the vertebrae from moving until the bone grafts fully healed.

Spine surgery will often provide full or partial relief of symptoms. Although future spine problems are possible for all patients after spine surgery. After spinal fusion, the area that was fused together can no longer move. Therefore, the spinal column above and below the fusion is more likely to be stressed when the spine moves, and have problems later. Also, if you needed more than one kind of back surgery (such as laminectomy and spinal fusion), you may have more of a chance of future problems.

As with any surgery there are certain risks involved. It is important to talk with your doctor about what treatment plan is right for you.

Linda Saisselin & Relief From Osteoarthritis

When Linda Saisselin was diagnosed with arthritis 10 years ago, she managed pretty well despite pain and swelling, which at that time was confined to her hands. She continued to fill out the paperwork required by her job as a social worker. She played the piano in her free time. But four years later, when arthritis affected her knees, pain plagued her every step. Living in New York City, Saisselin relied on walking and public transportation to get her everywhere. But walking became more and more difficult. Getting on and off the subway was even worse. Medicines to control the pain affected her concentration at work. Finally, when she could bear the pain no more, she had a total joint replacement surgery to replace her own damaged joint with a new artificial one‚ on the more painful of the two knees. Today, at 65, Saisselin enjoys hiking with her husband and holding her new grandson. Except for occasional swelling and pain in her hands, she is practically pain free.

Linda Saisselin is one of an estimated 43 million Americans with arthritis, a problem that is becoming more common as the population ages. By 2030 as many as 67 million Americans (one-fourth of the adult population) will have arthritis, according to CDC estimates. For many, that will mean daily pain, high medical costs and difficulty holding a job or doing everyday tasks, such as going up stairs, getting in and out of chairs, opening jars and buttoning shirts.

Although commonly referred to as if it were a single disease, arthritis is actually a term used for more than 100 conditions that cause pain, swelling and stiffness in the joints. Osteoarthritis (OA), the type Saisselin has, is the most common of the diseases. It affects 21 million Americans‚ about 10 times as many people as the second most common, rheumatoid arthritis (RA). RA is more common in women than men. It usually starts in the middle adult years. OA affects both sexes almost equally. It grows more common with age. One-third of people 65 and older have OA of the knee that can be seen on X-ray.

In OA, joint cartilage‚ the smooth, spongy tissue that covers the ends of the bones where they meet to form joints‚ breaks down. Bony growths, called spurs, form in the joints. The joints most likely to be affected are the hips and knees and those of the fingers, neck and lower back. In RA, the body's immune system‚ which normally defends us against invaders such as viruses and bacteria‚ attacks the membrane lining the joints. The joints usually affected are those of the hands, wrists, shoulders, elbows, knees, ankles and feet. If not stopped, this attack can cause joint damage and deformity.

In recent years, research has led to great advances in treating RA. For many people, drugs that modify the immune system improve symptoms and prevent joint damage. But for OA, treatment does little to help the disease's progression. For most people, treatment consists of medicine to control pain followed by surgery when pain is no longer controllable.

But there's hope on the horizon. Many scientists, including David T. Felson, M.D., MPH, chief of the Boston University Clinical Epidemiology Research Training Unit, believe research holds clues for better treating the disease and perhaps more importantly, preventing its development.

"I was always interested in things that were really common and where prevention was possible," says Dr. Felson, who has authored some 140 published studies on OA. Most of those studies were funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). "That wasn't possible in rheumatoid arthritis, although rheumatoid arthritis treatment is quite wonderful now. In osteoarthritis, treatment isn't so wonderful now, but prevention is a bigger opportunity."

The good news, says Dr. Felson, is that strategies to prevent the disease are the same ones that may help prevent its progression. In most cases the best medicine for osteoarthritis isn't medicine at all, but measures you can take and lifestyle changes you can make yourself.

For Saisselin, improvement came not just from her surgery, but from the physical therapy and lifestyle changes that followed. "I saw so much benefit from physical therapy that the physical therapist suggested it would be good for me to join a gym," she says. "Then, after I joined the gym, I started thinking, 'I just exercised for an hour, and now I'm going to put a cookie in my mouth?'"

As a result of her new exercise program and approach to eating, Saisselin lost 25 pounds. By the time she went back to the doctor for her six-month check-up, she realized the pain in the knee not replaced was gone, too.

Arthritis specialists, including Dr. Felson, say weight loss is one of the best things people can do for OA‚ either to prevent or ease it. "What we have found is that at every level of weight, a little bit higher increased the risk of OA for women," he says. "So if you take normal weight women and compare them to very thin women, normal-weight women are at higher risk." Conversely, he says, at every level of weight, if you lost a little weight, it would decrease your risk. And if you had pain in your knees it would likely help with that.

Ustekinumab - Effective for patients who don't respond to current treatments, study finds.

THURSDAY, Feb. 12 (HealthDay News) -- The drug ustekinumab shows promise against psoriatic arthritis (PA), according to a study that included patients from 24 sites in Europe and North America.

PA affects about 11 percent of patients with psoriasis, an autoimmune disease that affects the skin and joints. Some patients don't respond to current drug treatments for PA, so researchers are trying to find alternative therapies, according to background information in a news release about the study.

It's believed that interleukins 12 and 23 may play a role in PA. Interleukins are immune system-produced proteins that mediate inflammatory reactions in diseases such as psoriasis. Ustekinumab prevents interleukins 12 and 23 from binding to cell membranes.

In this study, patients were randomly assigned to receive either: ustekinumab (90 milligrams or 63 milligrams) every week for four weeks, followed by placebo at weeks 12 and 16 (76 patients -- Group 1); or placebo (weeks 0-3) and ustekinumab (63 milligrams) at weeks 12 and 16 (70 patients -- Group 2).

At week 12 of the trial, 42 percent of patients in Group 1 showed improvement, compared with 14 percent of those in Group 2. Of the 124 patients with psoriasis affecting 3 percent or more body surface area, 33 of 63 (52 percent) in Group 1 and three of 55 (5 percent) in Group 2 had a 75 percent or greater improvement in psoriasis area and severity index score at week 12 of the study.

"Our findings show that ustekinumab is efficacious and safe for treatment of active psoriatic arthritis. Our study is one of the first to implicate the role of interleukin 12/23 P40 cytokines in the pathophysiology of this disorder. Larger and longer term studies are needed to further characterize ustekinumab efficacy and safety for treatment of psoriatic arthritis," wrote Dr. Alice Gottlieb, of the dermatology department at Tufts Medical Center in Boston, and colleagues.

"The efficacy of ustekinumab for improving skin and joint involvement, which was maintained for several months, combined with good tolerability and a benign safety profile, make this agent an attractive option in psoriatic arthritis," Dr. Raquel S. Cuchacovich and Dr. Luis R. Espinoza, of LSU Health Sciences Center in New Orleans, wrote in an accompanying editorial.

Do I Need to Have My Joint Replaced?

Only a doctor can tell if you need a joint replaced. He or she will look at your joint with an x-ray machine or an arthroscope (a small, lighted tube), which they will put into your joint to look for damage. A small sample of your tissue may also be tested.

After looking at your joint, the doctor may suggest exercise, walking aids such as braces or canes, physical therapy, or medicines and vitamin supplements. Medicines for arthritis include drugs that reduce inflammation or, depending on the type of arthritis, the doctor may prescribe corticosteroids or other drugs. However, all drugs may cause side effects, including bone loss.

If these treatments do not work, the doctor may then suggest an operation called an osteotomy (pronounced aas-tee-AAHT-oh-me), where the surgeon aligns the joint. Here, the surgeon cuts the bone or bones around the joint to improve alignment. This may be simpler than replacing a joint, but it may take longer to recover. However, this operation is not commonly done today.

Joint replacement is often the answer if you have constant pain and can’t move the joint well, for example, if you have trouble with things such as walking, climbing stairs, and taking a bath.

Knowing what to expect if you are going in for surgery can help make the process less intimidating. First, the surgical team will provide you anesthesia so you won’t feel pain. The medicine may block the pain only in one part of the body (regional), or it may put your whole body to sleep (general). The team will then replace the damaged joint with a prosthesis.

Each surgery is different. How long it takes depends on how badly the joint is damaged and how the surgery is done. To replace a knee or a hip takes about 2 hours, unless there are complicating factors. After surgery, you will be moved to a recovery room for 1 to 2 hours until you are fully awake or the numbness goes away.

With knee or hip surgery, you may be able to go home in 3 to 5 days. If you are elderly or have additional disabilities, you may then need to spend several weeks in an intermediate-care facility before going home. You and your team of doctors will determine how long you stay in the hospital.

After hip or knee replacement, you will often stand or begin walking the day of surgery. At first, you will walk with a walker or crutches. You may have some temporary pain in the new joint because your muscles are weak from not being used. Also, your body is healing. The pain can be helped with medicines and should end in a few weeks or months.

Physical therapy can begin the day after surgery to help strengthen the muscles around the new joint and help you regain motion in the joint. If you have your shoulder joint replaced, you can usually begin exercising the same day of your surgery! A physical therapist will help you with gentle, range-of-motion exercises. Before you leave the hospital (usually 2 or 3 days after surgery), your therapist will show you how to use a pulley device to help bend and extend your arm.

The success of your surgery depends a lot on what you do when you go home. Follow your doctor’s advice about what you eat, what medicines to take, and how to exercise. Talk with your doctor about any pain or trouble moving.

Joint replacement is usually a success in more than 90 percent of people who have it. When problems do occur, most are treatable. Possible problems include:
- Infection - Areas in the wound or around the new joint may get infected. It may happen while you’re still in the hospital or after you go home. It may even occur years later. Minor infections in the wound are usually treated with drugs. Deep infections may need a second operation to treat the infection or replace the joint.

- Blood clots - If your blood moves too slowly, it may begin to form lumps of blood parts called clots. If pain and swelling develop in your legs after hip or knee surgery, blood clots may be the cause. The doctor may suggest drugs to make your blood thin or special stockings, exercises, or boots to help your blood move faster. If swelling, redness, or pain occurs in your leg after you leave the hospital, contact your doctor right away.

- Loosening - The new joint may loosen, causing pain. If the loosening is bad, you may need another operation. New ways to attach the joint to the bone should help.

- Dislocation - Sometimes after hip or other joint replacement, the ball of the prosthesis can come out of its socket. In most cases, the hip can be corrected without surgery. A brace may be worn for a while if a dislocation occurs.

- Wear - Some wear can be found in all joint replacements. Too much wear may cause loosening. The doctor may need to operate again if this occurs. Sometimes, the plastic can wear thin, and the doctor may just replace the plastic and not the whole joint.

- Nerve and blood vessel injury - Nerves near the replaced joint may be damaged during surgery, but this does not happen often. Over time, the damage often improves and may disappear. Blood vessels may also be injured.

As you move your new joint and let your muscles grow strong again, pain will lessen, flexibility will increase, and movement will improve.

Glucosamine, Promising Research: More is Needed

Glucosamine is a natural compound that is found in healthy cartilage. Glucosamine sulfate is a normal constituent of glycoaminoglycans in cartilage matrix and synovial fluid.

Based on human research, there is good evidence to support the use of glucosamine sulfate in the treatment of mild-to-moderate knee osteoarthritis. Although some studies of glucosamine have not found benefits, these have either included patients with severe osteoarthritis or used products other than glucosamine sulfate. The evidence for the effect of glycosaminoglycan polysulphate is conflicting and merits further investigation. Better-designed clinical trials are needed to confirm safety and effectiveness, and to test different formulations of glucosamine.

Several human studies and animal experiments report benefits of glucosamine in treating osteoarthritis of various joints of the body, although the evidence is less plentiful than that for knee osteoarthritis. Some of these benefits include pain relief, possibly due to an anti-inflammatory effect of glucosamine, and improved joint function. Overall, these studies have not been well designed. Although there is some promising research, more study is needed in this area before a firm conclusion can be made.

Early human research reports benefits of glucosamine in the treatment of joint pain and swelling in rheumatoid arthritis. In other research, glucosamine did not exert anti-rheumatic effects, but it did improve symptoms of the disease. However, this is early information, and additional research is needed before a conclusion can be drawn. The treatment of rheumatoid arthritis can be complicated, and a qualified healthcare provider should follow patients with this disease.

The U.S. Food and Drug Administration do not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

What is Joint Replacement Surgery?

Joint replacement surgery is removing a damaged joint and putting in a new one. A joint is where two or more bones come together, like the knee, hip, and shoulder. The surgery is usually done by a doctor called an orthopaedic (pronounced or-tho-PEE-dik) surgeon. Sometimes, the surgeon will not remove the whole joint, but will only replace or fix the damaged parts.

The doctor may suggest a joint replacement to improve how you live. Replacing a joint can relieve pain and help you move and feel better. Hips and knees are replaced most often, but other joints including the shoulders, fingers, ankles, and elbows can be replaced.

Joints can be damaged by arthritis and other diseases, injuries, or other causes. Arthritis or simply years of use may cause the joint to wear away. This can cause pain, stiffness, and swelling. Bones are alive, and they need blood to be healthy, grow, and repair themselves. Diseases and damage inside a joint can limit blood flow, causing problems.

A new joint, called a prosthesis (pronounced praas-THEE-sis), can be made of plastic, metal, or both. It may be cemented into place or not cemented, so that your bone will grow into it. Both methods may be combined to keep the new joint in place.

A cemented joint is used more often in older people who do not move around as much and in people with weak bones. The cement holds the new joint to the bone. An uncemented joint is often recommended for younger, more active people and those with good bone quality. It may take longer to heal, because it takes longer for bone to grow and attach to it.

New joints generally last at least 10 to 15 years. Therefore, younger patients may need to have the same damaged joint replaced more than once.

Joint replacement is becoming more common, in fact about 773,000 Americans have a hip or knee replaced each year. Research has shown that even if you are older, joint replacement can help you move around and feel better.

Any surgery has risks. And the risks associated with joint surgery will depend on your health before surgery, how severe your arthritis is, and the type of surgery done. Many hospitals and doctors have been replacing joints for several decades, and this experience results in better patient outcomes. For answers to their questions, some people talk with their doctor or someone who has had the surgery. A doctor specializing in joints will probably work with you before, during, and after surgery to make sure you heal quickly and recover successfully.