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Treating headaches, backaches and sore joints safely

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As we age, aches and pains become more frequent. According to a University of Michigan survey on healthy aging in 2022, 70 percent of those between 50 and 80 years old report joint pain.

The study found that in many cases, people reach for over-the-counter drugs such as acetaminophen or ibuprofen. They ask their doctor less often about the risks associated with these medications.

Beth Wallace, a Michigan rheumatologist who is also the co-author of this research, says: “This is problematic.” Ibuprofen, as well as other nonsteroidal antiinflammatory drugs (NSAIDs), can cause stomach problems. High doses of acetaminophen may also damage the liver. Then there are the side effects that can come with taking stronger pain medications.

Here are four common types and their safe treatment.

According to a Mayo Clinic study, almost 20 percent of people over 65 have headaches at least twice a week. Most common are tension headaches (which can cause pressure on both side of the brain) and migraines.

Ease pain: Acetaminophen and NSAIDs can be used to treat mild headaches. Alan M. Rapoport is a UCLA professor of neurology and says that taking NSAIDs to treat headaches can actually worsen the situation by triggering medication overuse headaches.

Rapoport recommends that you see a doctor if your headaches are more than twice per month or if they interfere with your daily life. It could be helpful to try non-drug treatments and possibly medication. Some research suggests that acupuncture may be helpful. There’s also better evidence that biofeedback training can help headache sufferers by controlling their breathing, heart rate and other functions.

In some cases prescription drugs may be appropriate. Sumatriptan and other triptans are prescribed to treat migraines. However, they should be taken cautiously, especially by older patients at risk of stroke or heart disease.

Doctors may prescribe amitriptyline and nortriptyline in small doses for persistent tension headaches. Rapoport says that although these drugs are antidepressants they may also relieve these headaches.

Aching feet

According to a study published in the journal Arthritis Care & Research, up to one-third (33%) of adults 65 years and older experience foot pain regularly.

According to Sean Peden, an orthopedic foot and ankle surgeon at Yale Medicine, Stamford, Conn., osteoarthritis is a common age-related factor. It is a wear away of cartilage between the foot joints.

As people age, they also lose some cushioning at the bottom of their foot. Peden says that this causes you to walk more on the bones in your feet than on the fat padding. This causes pain.

Ease pain: Invest in the right footwear. Peden recommends a shoe that has a hard sole, but is cushioned in the middle. This would be Birkenstocks or sturdy shoes.

He says stretching is also a good idea. Muscles tighten as we age, causing sore tendons and foot muscles. He recommends calf stretches and sitting hamstring stretching. He says that when these muscles are loose, they put less pressure on the foot.

Try applying Voltaren, an OTC anti-inflammatory lotion. Physical therapy can help stimulate nerves and relieve tingling, numbness, or weakness. If you are experiencing pain due to the loss of fat on your feet, try wearing cushioned shoes, inserts or padded shoe covers.

Osteoarthritis can also cause knee pain. However, some people may treat it incorrectly.

According to a Michigan poll, 26 per cent of older adults with joint pain or knee pain take supplements like glucosamine and/or chondroitin. Wallace says that research on these supplements shows they do not help and that high doses can be harmful.

Some people are turning to CBD or marijuana. Wallace says that there is not enough evidence to support or disprove their use in treating knee pain.

Ease pain: Exercise, weight loss and other measures, when appropriate, can help ease knee osteoarthritis pain and prevent it from getting worse, according to Jesse Charnoff a physiatrist with the Hospital for Special Surgery, New York. Low-impact exercises such as walking, biking, rowing, and deep-water-running are also important for strengthening muscles around the knee.

Not enough? Acetaminophen may help, particularly “if you take the medication every eight hours, as recommended, instead of waiting until pain becomes unbearable,” Wallace explains. There are two other options: a topical NSAID like Voltaren, and steroid injections for severe pain.

The American College of Rheumatology warns against hyaluronic-acid injections. The ACR doesn’t have enough evidence to support their use, and some studies indicate that they could be associated with harmful effects.

Lower back pain

In a survey conducted by the National Center of Health Statistics in 2019, more than 45 percent of those 65 and older reported having back pain within the last three months.

Matthew Chong, a spine specialist at the Cedars-Sinai Kerlan-Jobe Institute, Los Angeles, says that osteoarthritis is a common cause. Osteoarthritis is painful, but it can cause spinal stenosis. This narrowing of spine puts pressure on back nerves and the spinal cord. Other triggers are muscle strains and fractures.

Reduce the pain: If you have lower back pain that is not relieved by NSAIDs or acetaminophen, it’s best to begin with non-drug measures. Staying active is one of the best ways to ease back pain. Rest your back if you are experiencing significant pain. This should not be more than a few days. Chong says that movement helps relieve muscle spasms, and prevents muscle weakness. He says that using a heating wrap or pad a few times a week could also be helpful.

If your doctor tells you that your pain is caused by compression fractures, the treatment will usually be rest, OTC pain relief or back bracing.

After your back pain has subsided, strengthening and stretching exercises can help. Walking, swimming, biking, low-impact aerobics and yoga can all help. Chong suggests that you try them out on your own for several weeks and then, if necessary, ask for a referral for physical therapy.

Trigger-point injections are sometimes used as a temporary solution before physical therapy or other treatment kicks in. Steroid injections may also provide temporary relief.

Surgery should only be used as a last option. Chong says that we tend to give patients the full range of conservative treatments first.

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