Pain Management

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.

How can I manage my arthritis pain while traveling?

DEAR DOCTOR K: Can you give me advice for managing arthritis pain while traveling?

DEAR READER: Vacations often involve being more physically active than normal, which can worsen arthritis pain. But arthritis doesn't have to spoil your vacation. I spoke to my colleague Dr. Susan Ritter, associate physician in the Division of Rheumatology, Immunology and Allergy at Harvard-affiliated Brigham and Women's Hospital. She made the following suggestions to help make travel relatively pain- and hassle-free:

How can I relieve knee and hip pain without drugs or surgery?

DEAR DOCTOR K: I have constant knee and hip pain. How can I relieve my pain without drugs or surgery?

DEAR READER: For several years, I asked myself the same question. I had severe arthritis in my right hip, the result of a sports injury when I was a young adult. The pain really was interfering with my life. I was limping, and that made me feel old. Worse, I loved long walks -- particularly in new places, on vacation -- and I just couldn't do it anymore. But I didn't want to have surgery.

Is there a drug-free way to relieve PMS symptoms?

DEAR DOCTOR K: Every month I have awful PMS. Can you suggest drug-free ways to relieve my symptoms?

DEAR READER: Premenstrual syndrome (PMS) is a collection of symptoms that occur just before and during menstruation. The most common symptom is unusual mood swings. In addition, women with PMS also experience irritability, anxiety, depression, headaches, hot flashes, bloating, abdominal cramping, breast tenderness and food cravings.

What are treatments for chronic neuropathic pain?

DEAR DOCTOR K: I suffer from what my doctor calls "chronic neuropathic pain." What are my treatment options?

DEAR READER: There are two main types of pain. Nociceptive pain results from an injury to tissues outside your nervous system. Burns, sprains and broken bones are all examples of nociceptive pain. Tiny nerve fibers are always present in tissues. When the tissue gets injured, the nerve fibers detect it. The signal they send the brain is nociceptive pain. The signal says to the brain: "Do something to avoid further injury!"

How can I relieve the pain from my injured rotator cuff?

DEAR DOCTOR K: I've injured my rotator cuff. What can I do to relieve the pain?

DEAR READER: When people hear "rotator cuff injury," they often think of baseball pitchers. But most people with rotator cuff injuries are like you and me. Gradual wear and tear from everyday activities, over many years, makes all older adults vulnerable to such injuries.