Pain Management

What are alternative therapies for rheumatoid arthritis pain?

DEAR DOCTOR K: I have rheumatoid arthritis. Medications have helped, but only up to a point. Can you discuss alternative therapies that might help to further relieve my discomfort?

DEAR READER: Rheumatoid arthritis (RA) is a long-term disease in which the body's immune system attacks healthy tissue lining the joints. This causes swelling, pain, redness and stiffness in joints throughout the body. Drug treatments slow the effects of the disease, but alternative approaches can also help to reduce inflammation and relieve pain.

What happens during chiropractic treatment — what types of pain can it relieve?

DEAR DOCTOR K: I've been having back problems, and frankly, my regular doctor hasn't come up with treatments that help me much. So I'm wondering: What happens during chiropractic treatment? What types of pain can it relieve?

DEAR READER: Regular readers of this column know that I'm not very stuffy. I think treatments that are called "complementary" or "alternative" medicine should not be dismissed out of hand. Instead, those treatments that many people have found helpful -- and that are not clearly dangerous -- should be studied in the same way that traditional medical treatments are.

How can I relieve my knee pain without surgery?

DEAR DOCTOR K: I'm in my 60s. My knees have started to hurt, especially when I'm climbing stairs. Can you recommend any nonsurgical ways to relieve this pain?

DEAR READER: Knee pain is one of the most common reasons for doctor visits. As you get older, knee pain can limit your mobility and take away your independence. The keys to keeping your knees healthy? Strengthening muscles around the knees, improving balance and losing weight.

Should I stop drinking if I have chronic pancreatitis?

DEAR DOCTOR K: I have chronic pancreatitis. Will it help to stop drinking at this point? Or is it too late?

DEAR READER: It is never too late to stop further damage to the pancreas, but it may be too late to reverse damage done in the past. However, that's water under the bridge. What you want to do now is stop further damage.

How can I prevent addiction to my prescription painkillers?

DEAR DOCTOR K: My doctor has prescribed prescription painkillers -- opioids -- for my severe back pain. They relieve my pain, but how can I reduce my risk of becoming hooked?

DEAR READER: Simply being aware of the risk of addiction is a good first step in ensuring that you do not become addicted to prescription painkillers. I'll explain a little bit about painkillers. Then I'll describe some steps you can take to prevent addiction.

What are drug-free treatments to relieve osteoarthritis hand pain?

DEAR DOCTOR K: I have osteoarthritis in my hand. Could you recommend some drug-free treatments to relieve the pain?

DEAR READER: Osteoarthritis causes stiffness and pain in the joints. It develops when cartilage -- the connective tissue that covers the ends of bones -- deteriorates. In a joint, the ends of two or more bones come together. The softer and more flexible cartilage that covers the ends of the bones acts as a cushion. If the cartilage were not there, the hard bones would grind against each other.

What are some simple changes that help relieve neck pain?

DEAR DOCTOR K: I'm a woman in my late 40s, and I have mild but aggravating neck pain that flares up from time to time. Can you suggest simple changes I can make at home and at work that might help?

DEAR READER: There are many things you can do to minimize your risk of recurring neck pain. Start by keeping your neck in a neutral position whether you are sitting or standing. That means your head should balance directly over your spine and not lean forward or be cocked to one side.

How can I relieve knee pain from chondromalacia?

DEAR DOCTOR K: I saw my doctor because of aching pain in my knee, which sometimes buckles unexpectedly. He says I have chondromalacia. What is this, and what can I do to relieve the pain?

DEAR READER: The joints in your body are cushioned by cartilage. This tough, rubbery tissue covers and protects the ends of bones inside a joint, allowing them to glide smoothly against one another as the joint moves. With chondromalacia, the cartilage inside a joint softens and breaks down. The ends of the bones can rub together, causing pain. Chondromalacia can affect any joint, but the most common location is inside the knee, see the illustration on the right.

Will steroid shots relieve spinal stenosis pain?

DEAR DOCTOR K: I have spinal stenosis. Will steroid shots help with pain relief?

DEAR READER: Spinal stenosis is a narrowing of the open space in the spinal canal. This squeezes nerves, causing pain in the lower back, buttocks and legs. I have spinal stenosis, so I know about it both as a physician and a patient. Medicines and physical therapy are usually the first treatments for spinal stenosis pain.

What is the best treatment for cubital tunnel syndrome?

DEAR DOCTOR K: I have cubital tunnel syndrome. What's the best treatment for it?

DEAR READER: Cubital tunnel syndrome is a trapped or pinched nerve problem, much like its better-known relative, carpal tunnel syndrome. Cubital tunnel syndrome occurs when the ulnar nerve gets compressed. The ulnar nerve extends from the spinal cord in your neck to your forearm and the pinky side of your hand. The nerve passes through a series of passageways, or tunnels. The tunnels are composed of tough layers of fibers that can pinch the nerve running through them.