JOINT HEALTH NEWS

ScienceDaily — Chronic Pain Costs U.S. Up to $635 Billion, Study Shows

Health economists from Johns Hopkins University writing in The Journal of Pain reported the annual cost of chronic pain is as high as $635 billion a year, which is more than the yearly costs for cancer, heart disease and diabetes.

Previous studies have not shown a comprehensive analysis of the impact on health care and labor markets associated with people with chronic pain. The Johns Hopkins researchers estimated the annual economic costs of chronic pain in the U.S. by assessing incremental costs of health care due to pain and the indirect costs of pain from lower productivity. They compared the costs of health care for persons with chronic pain with those who do not report chronic pain.

Data from the 2008 Medical Expenditure Panel Survey was used to gauge the economic burden of pain in the United States. The sample included 20,214 individuals 18 and older to represent 210.7 million U.S. adults.

The authors defined persons with pain as those who have pain that limits their ability to work, are diagnosed with joint pain or arthritis, or have a disability that limits capacity for work. To measure indirect costs, they used a model to predict health care costs if someone has any type of pain and subtracted predicted health care costs of persons who do not have pain. The impact of incremental costs of selected pain conditions were calculated for various payers of health care services.

Results showed that mean health care expenditures for adults were $4,475. Prevalence estimates for pain conditions were 10 percent for moderate pain, 11 percent for severe pain, 33 percent for joint pain, 25 percent for arthritis, and 12 percent for functional disability. Persons with moderate pain had health care expenditures $4,516 higher than someone with no pain, and individuals with severe pain had costs $3,210 higher than those with moderate pain. Similar differences were found for other pain conditions: $4,048 higher for joint pain, $5,838 for arthritis, and $9,680 for functional disabilities.

Also, adults with pain reported missing more days from work than people without pain. Pain negatively impacted three components of productivity: work days missed, number of annual hours worked and hourly wages.

Based on their analysis of the data, the authors determined that that the total cost for pain in the United States ranged from $560 to $635 billion. Total incremental costs of health care due to pain ranged from $261 to $300 billion, and the value of lost productivity ranged from $299 to $334 billion. Compared with other major disease conditions, the per-person cost of pain is lower but the total cost is higher.

The authors noted their conclusions are conservative because the analysis did not consider the costs of pain for institutionalized and non-civilian populations, for persons under 18 and for caregivers.

The Journal of Pain is published by the American Pain Society.

American Pain Society (2012, September 11). Chronic pain costs U.S. up to $635 billion, study shows. ScienceDaily. from http://www.sciencedaily.com­ /releases/2012/09/120911091100.html

Need a New Hip? Someday You May Grow Your Own - By Dennis Thompson - HealthDay Reporter

(HealthDay News) -- In a decade or so, people now clamoring for metal and ceramic replacement joints may instead be able to have a fully functional biological replacement -- a joint grown within their own bodies to their specific physiology.

To date, researchers have successfully grown replacement shoulder joints in rabbits, using an implanted biological "scaffold" upon which new cartilage developed, according to a study reported in The Lancet.

"It's definitely a major step forward," said Dr. Thomas A. Einhorn, chairman of orthopaedic surgery and a professor of orthopaedics, biochemistry and biomedical engineering at Boston University and a spokesman for the American Academy of Orthopaedic Surgeons. "It's excellent work."

However, people with arthritis or degenerative joint conditions should not expect to take advantage of this medical advance any time in the immediate future. Clinical use of the new technology is still a decade or more away, said Einhorn and Dr. James L. Cook, a veterinarian and director of the Comparative Orthopaedic Laboratory at the University of Missouri, and a member of the research team.

"You're probably looking at the eight- to 10-year mark before it becomes widely available," Cook said. "I tell everyone we're working as hard as we can. I get a ton of calls from patients who say, 'I'll fly wherever I can, I'll pay whatever I have to, I'll sign whatever you want me to. I don't want metal or plastic. I don't want an artificial joint.'"

The new process works by implanting in the damaged joint what's called a bioscaffold, which has been infused with a medication known as transforming growth factor beta-3. The drug encourages the body's own cells -- stem cells included -- to become cartilage and bone cells.

The scaffold is made from polycaprolactone, a biodegradable plastic, and hydroxyapatite, a naturally occurring mineral found in bone and teeth.

Researchers removed the entire humeral head -- the ball part of ball-and-socket shoulder joints -- from rabbits used as test subjects and then implanted the scaffolds to grow a biological replacement for the missing piece.

The study reported that the rabbits implanted with the drug-infused scaffolds were able to use the joints and support themselves with them faster and more consistently than rabbits not given the scaffolds. After four months, a new cartilage surface for the humeral head had grown in place, with no complications or adverse effects, the researchers reported.

"They've been able to demonstrate that using a specific type of scaffold that's been doped with a specific type of growth factor, cells will basically populate the scaffold and create cartilage," Einhorn said.

Though apparently sound, the process still faces years of testing, mainly because it involves the use of an experimental cell growth factor, Einhorn and Cook said.

"We feel that clinically it works, but there's still a lot of safety testing on the human side to get [U.S. Food and Drug Administration] approval," Cook said. "The FDA wants to see it's safe, it's the same product every time, and there are no problems with disease transmission or infection."

Einhorn said the durability of the biological joints also must be considered.

"The stability needs to be tested," he said. "Is it going to be able to withstand the wear and tear that occurs through use on a daily basis, or is it something that just looks good now but will break down quickly?"

Cook has high hopes that the biological replacement joints will prove superior to the artificial joints now used, providing recipients with a higher degree of function.

"A metal and plastic joint is at its best condition the day you put it in," he said. "The plastic wears out. Even the metal can wear out. A biological joint can actually improve over time as it adapts to your body."

And though excited and intrigued by the research, Einhorn warned that people should not get their hopes up too soon.

"It's not an answer for the middle-aged patient who has arthritis now, but it may be an answer for the middle-aged patient who has arthritis in the next 10 to 20 years," he said.

FDA Warns Consumers about Popular Natural Dietary Supplement from Mexico

In spite of an earlier report in June by the FDA warning consumers that the popular dietary supplement Reumofan Plus contains non-natural prescription drugs, reports of users suffering complications from taking this supplement continue. As such, a message worth bearing repeating is that unless users discontinue taking this supplement, they run an increased risk of internal bleeding, stroke and death.

Reumofan Plus is advertised as a natural dietary supplement that provide relief for sufferers' of arthritis and a wide range of musculoskeletal problems—particularly pain in the joints.

Arthritis-related joint problems are a common complaint of aging and one that can greatly lessen an individual's quality of life. Arthritis involves inflammation and stiffness around the joints that can damage the cartilage that allows bones in joints to slide easily over one another. Simple daily tasks such as walking, climbing stairs, brushing your teeth and cutting your food during mealtime can become very difficult and painful as arthritis progresses.

Reumofan Plus is marketed as a natural remedy for arthritis that reportedly contains a number of natural ingredients including botanical compounds from plants found only in Mexico and Cuba, shark cartilage, glucosamine, vitamin C and calcium. However, according to the findings of officials from the U.S. Food and Drug Administration, what's not on the label is what consumers should be worried about.

In a press release issued by the FDA, Reumofan Plus contains:

• Diclofenac sodium—a prescription non-steroidal anti-inflammatory drug (NSAID) that may cause increased risk of cardiovascular events such as heart attack and stroke, as well as serious gastrointestinal (GI) adverse events including bleeding, ulceration, and fatal perforation (i.e. causing a hole) of the stomach and intestines.

• Methocarbamol – a prescription muscle relaxant that can cause sedation, dizziness, low blood pressure, and impair mental or physical abilities to perform tasks such as driving a motor vehicle or operating machinery.

In addition, the FDA also reports that some lots of Reumofan supplements have been found to contain the anti-inflammatory drug dexamethasone that can cause suppression of a person's immune system. While Mexican health and government officials have worked toward recalling the Reumofan supplements and stopping production by manufacturer Riger Naturals, sale of the supplement continues at flea markets, outlet retail stores and the Internet.

At least one confirmed report of an adverse reaction linked to Reumofan use includes a case of confirmed adrenal suppression that interferes with normal kidney function. Other adverse reactions including liver damage, sudden worsening of blood glucose levels, weight gain, swelling, and leg cramps have all been linked to users of Reumofan supplements. Another serious concern is the possibility that the ingredients in Reumofan Plus may interfere with the actions of prescribed medications.

FDA officials also warn that discontinuing taking Reumofan Plus can result in abrupt discontinuation complications that include fatigue, nausea, low blood pressure, low blood sugar levels, fever, muscle, and joint pain, dizziness, and fainting from long-term use or high doses of Reumofan pills that contain corticosteroids. Avoidance of these complications may require a taper regimen directed by a physician.

The FDA advises users of Reumofan products to contact their physician immediately and alert them about the use of Reumofan Plus and report any side effects experienced.

Reference: FDA press release: FDA issues alert on Reumofan Plus

Nightshade vegetables trigger arthritis

Vegetables are a healthy component of a well balanced diet. Many people include them in their daily meal. But, imagine sitting down to a tasty meal of eggplant Parmesan. That's a dish I love to make. Or think about sinking your teeth into a spicy dish of vegetable lasagna with tomato sauce. Then imagine that your doctor said you should not eat eggplant or tomatoes or some of your other favorite foods like white potatoes, sweet and hot peppers or huckleberry (the fruit, not the yokel).

Maria received that bad news when she was recently diagnosed with arthritis.

Arthritis is an inflammation of the joints. Many individuals have this condition and still are able to lead active lives. One way they can do this is, according to some folks, is by not eating over 2,800 species of plants including the ones mentioned above. These edibles are all members of what botanists identify as "Nightshades."

Nightshades are not characters in a Tom Clancy novel nor a new device to view drive-in movies.

Nightshades are plants that are grown in the shade of night, hence the name. (It doesn't take a rocket scientist to be a botanist- with all due respect to the members of that noble profession.)

These varieties also include ground cherries, pimentos, paprika and cayenne peppers.

The offending component of nightshades that cause problems for some people with arthritis is thought to be the alkaloids. Alkaloids seem to interfere with calcium metabolism.

Calcium metabolism is the process whereby the body breaks down calcium to strengthen bones and body tissues.

One theory is that nightshades remove calcium from bone and deposit it in soft tissue and thus softening the bones. Another theory is that nightshades are pro-inflammatory substances, provoking inflammatory reactions in the body.

Most of these theories are formed from surveys and patient input rather than scientific studies.

However there are instances of people suffering from arthritis who encounter worse symptoms after consuming nightshades. That was Maria's experience. She noticed that, after eating a lot of eggplant and tomatoes, she developed arthritis flares.

Doctors use the term "flare" to describe an increase in a patient's symptoms above and beyond their usual symptoms.

There are other examples of people who eliminate these vegetables with the result of decreasing their inflammation.

Some doctors and researchers suggest eliminating nightshades for a couple of weeks to see if the symptoms improve.

Nightshades contain ingredients used within modern and herbal medicine. And, although these plants and their chemical components are generally used to promote good health, some of them can be toxic when eaten in large quantities or when given to people who are sensitive to nightshades.

That's because these unique plants have developed a means of defending themselves against predators who might want to consume them.

These predators are small creatures like bugs or insects. Nightshades will produce a toxic substance to protect themselves from being eaten. However these toxins can also cause an allergic reaction or food sensitivity in some people and may increase joint disorders, digestive problems and other health related problems.

Eliminating nightshades isn't the only way to relieve arthritis.

You should first consult with your physician to seek relief. Some remedies may include including herbal supplements such as turmeric, ginger root, natural honey and the raison and gin concoction that I have referred to previously (please use responsibly) and which Maria has to reduce inflammation.

Others remedies may include rest or a prescription of steroids.

It should be noted that sweet potatoes, yams and black pepper are not included among the nightshades. So you can eat all of those to your hearts content.

I should also confess that, even though tomatoes and eggplant are taboo for Maria, just today I did keep up a tradition passed along to me by my mother and I picked a bushel of tomatoes for canning and a half- bushel of eggplant for cooking and preserving.