Do you have knee pain from osteoarthritis? You might not need surgery. Here’s what to try instead
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Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to updated treatment guidelines from the Australian Commission on Safety and Quality in Health Care.
So what is knee osteoarthritis and what are the best ways to manage it?
More than 2 million Australians have osteoarthritis
Osteoarthritis is the most common joint disease, affecting 2.1 million Australians. It costs the economy A$4.3 billion each year.
Osteoarthritis commonly affects the knees, but can also affect the hips, spine, hands and feet. It impacts the whole joint including bone, cartilage, ligaments and muscles.
Most people with osteoarthritis have persistent pain and find it difficult to perform simple daily tasks, such as walking and climbing stairs.
Is it caused by ‘wear and tear’?
Knee osteoarthritis is most likely to affect older people, those who are overweight or obese, and those with previous knee injuries. But contrary to popular belief, knee osteoarthritis is not caused by “wear and tear”.
Research shows the degree of structural wear and tear visible in the knee joint on an X-ray does not correlate with the level of pain or disability a person experiences. Some people have a low degree of structural wear and tear and very bad symptoms, while others have a high degree of structural wear and tear and minimal symptoms. So X-rays are not required to diagnose knee osteoarthritis or guide treatment decisions.
Telling people they have wear and tear can make them worried about their condition and afraid of damaging their joint. It can also encourage them to try invasive and potentially unnecessary treatments such as surgery. We have shown this in people with osteoarthritis, and other common pain conditions such as back and shoulder pain.
This has led to a global call for a change in the way we think and communicate about osteoarthritis.
What’s the best way to manage osteoarthritis?
Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms. These include education and self-management, exercise and physical activity, weight management and nutrition, and certain pain medicines.
Education is important to dispel misconceptions about knee osteoarthritis. This includes information about what osteoarthritis is, how it is diagnosed, its prognosis, and the most effective ways to self-manage symptoms.
Health professionals who use positive and reassuring language can improve people’s knowledge and beliefs about osteoarthritis and its management.
Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as paracetamol and anti-inflammatories and can prevent or delay the need for joint replacement surgery in the future.
Many types of exercise are effective for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi. So you can do whatever type of exercise best suits you.
Increasing general physical activity is also important, such as taking more steps throughout the day and reducing sedentary time.
Weight management is important for those who are overweight or obese. Weight loss can reduce knee pain and disability, particularly when combined with exercise. Losing as little as 5–10% of your body weight can be beneficial.
Pain medicines should not replace treatments such as exercise and weight management but can be used alongside these treatments to help manage pain. Recommended medicines include paracetamol and non-steroidal anti-inflammatory drugs.
Opioids are not recommended. The risk of harm outweighs any potential benefits.
What about surgery?
People with knee osteoarthritis commonly undergo two types of surgery: knee arthroscopy and knee replacement.
Knee arthroscopy is a type of keyhole surgery used to remove or repair damaged pieces of bone or cartilage that are thought to cause pain.
However, high-quality research has shown arthroscopy is not effective. Arthroscopy should therefore not be used in the management of knee osteoarthritis.
Joint replacement involves replacing the joint surfaces with artificial parts. In 2021–22, 53,500 Australians had a knee replacement for their osteoarthritis.
Joint replacement is often seen as being inevitable and “necessary”. But most people can effectively manage their symptoms through exercise, physical activity and weight management.
The new guidelines (known as “care standard”) recommend joint replacement surgery only be considered for those with severe symptoms who have already tried non-surgical treatments.
I have knee osteoarthritis. What should I do?
The care standard links to free evidence-based resources to support people with osteoarthritis. These include:
- education, such as a decision aid and four-week online course
- self-directed online exercise and yoga programs
- weight management support
- pain management strategies, such as MyJointPain and painTRAINER.
If you have osteoarthritis, you can use the care standard to inform discussions with your health-care provider, and to make informed decisions about your care.
Belinda Lawford, Postdoctoral research fellow in physiotherapy, The University of Melbourne; Giovanni E. Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney; Joshua Zadro, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, University of Sydney, and Rana Hinman, Professor in Physiotherapy, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Beat Cancer Kitchen – by Chris Wark & Micah Wark
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When we eat, many things can increase our cancer risk. Some we might remember to avoid, like ultra-processed foods and red meat. Others might be more neutral when it comes to cancer, neither good nor bad.
But! Some foods also have cancer-fighting properties. Which means reducing cancer risk, and/or having an anti-proliferative effect (i.e., shrinks or at least slows growth of tumors), in the event of already having cancer.
That’s what Chris & Micah Wark are offering here; a cookbook built around anti-cancer foods—after the former beat his own cancer with the help of the latter. He had surgery, but skipped chemo, preferring to look to nutrition to keep cancer-free. Now 18 years later, and so far, so good.
The dietary advice here is entirely consistent with what we’d offer at 10almonds; it’s plant-based, and high in anti-cancer phytonutrients.
The recipes themselves (of which there are about 70-ish) are as delicious and simple as the title suggests, and/but you might want to know:
- On the one hand, many recipes are things like sauces, condiments, or dressings, which in a recipe book can sometimes feel like underdelivering on the promise of recipes when we expect full meals
- On the other hand, those things if you just purchase them ready-made are usually the things with the most ultra-processed products, thus, having anticancer homemade versions instead here can actually make a very big difference
- On the third hand, there areplenty of starters/mains/desserts too!
Bottom line: if you’re looking for an anti-cancer cookbook, this is a very good one whose ingredients aren’t obscure (which can otherwise be a problem for some books of this kind)
Click here to check out Beat Cancer Kitchen, and take good care of yourself and your loved ones!
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How To Be 7.5x More Likely To Develop Chronic Fatigue Syndrome
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First, what is it?
Many more people have chronic fatigue, which is the symptom of being exhausted all the time, than have chronic fatigue syndrome (CFS) which is the illness of myalgic encephalomyelitis (ME).
This is because fatigue can be a symptom of many, many other conditions, and can be heavily influenced by lifestyle factors too.
A lot of the advice for dealing with chronic fatigue is often the same in both cases, but some will be different, because for example:
- If your fatigue is from some other condition, that condition probably impacts what lifestyle factors you are (and are not) able to change, too
- If your fatigue is from lifestyle factors, that hopefully means you can change those and enjoy less fatigue…
- But if it’s not from lifestyle factors, as in ME/CFS, then advice to “exercise more” etc is not going to help so much.
There are ways to know the difference though:
Check out: Do You Have Chronic Fatigue Syndrome?
The chronic disease pipeline
While it had been strongly suspected that COVID infection could lead to CFS, with long COVID having chronic fatigue as one of its characteristic symptoms, a research team led by Dr. Suzanne Vernon has now established the nature of the relationship.
It was a large (n=13,224) longitudinal observational cohort study of people with no pre-existing ME/CFS, grouped according to their COVID infection status:
- acute infected, enrolled within 30 days of infection or enrolled as uninfected who became infected (n=4,515)
- post-acute infected, enrolled greater than 30 days after infection (n=7,270)
- uninfected (n=1,439).
(to be clear, that last means “never infected”, or else they would be in group 2)
Note: people who had COVID and were hospitalized for it were excluded from the study, so this risk is the risk represented by even just more “moderate” infections.
What they found:
❝The proportion of all RECOVER-Adult participants that met criteria for ME/CFS following SARS-CoV-2 infection was 4.5% (531 of 11,785) compared to 0.6% (9 of 1439) in uninfected participants.❞
There are then different numbers if we look per 100 person-years, as the study also did—in which case, we get a re-modelled increase in risk of 5x instead of 7.5x, but a) that’s still not good b) the “here-and-now” figures of 4.5% vs 0.6% are also relevant.
Read in full: Incidence and Prevalence of Post-COVID-19 Myalgic Encephalomyelitis: A Report from the Observational RECOVER-Adult Study
The killer nobody wants to talk about anymore
Of course, as we all know the pandemic is over, because politicians declared it so, which is very reassuring.
Nevertheless, COVID is currently the still 4th leading cause of death in the US, placing it higher than stroke, Alzheimer’s, diabetes, and others.
See also: Emergency or Not, Covid Is Still Killing People. Here’s What Doctors Advise to Stay Safe
So, while it’s very good to take care of our hearts, brains, blood sugars, and so forth, let’s at the very least continue to keep on top of our vaccinations, avoid enclosed crowded spaces where possible, etc.
And for extra boosts to one’s chances: Why Some People Get Sick More (And How To Not Be One Of Them)
What if I do get (or already have) long COVID and/or ME/CFS?
Well, that is definitely going to suck, but there are still some things that can be done.
Here’s a big one: How To Eat To Beat Chronic Fatigue ← this will not, of course, cure you, but it’s a way of getting maximum nutrition for minimum effort, given that for someone with chronic fatigue, effort is a very finite resource that must be used sparingly
Finally, here are some further resources:
Support For Long COVID & Chronic Fatigue
Take care!
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Mango vs Pineapple – Which is Healthier?
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Our Verdict
When comparing mango to pineapple, we picked the pineapple.
Why?
It was close! Both of these tropical fruits have almost identical macros, and when it comes to vitamins and minerals, mango has slightly more vitamins while pineapple has slightly more minerals, so that balances out too. Their glycemic loads are 11 and 13 respectively, so: very low, and very similar.
See also: Which Sugars Are Healthier, And Which Are Just The Same?
In terms of what sets them apart:
Mango has a lot of vitamin A, to the point that it can interfere with blood-thinners if you take those.
Pineapple has bromelain, an enzyme with unique anti-inflammatory properties that we must devote a Research Review Monday to one of these days, because there’s a lot to say, but the short version is, it’s very powerful.
Since bromelain is found only in pineapples, whereas vitamin A is easy to find in abundance in many foods, we went with the pineapple.
Enjoy!
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The Little-Known Truth…
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Myth-Buster, Myth-Buster, Bust Us A Myth (or three!)
Let’s can this myth for good
People think of “canned foods” as meaning “processed foods” and therefore bad. But the reality is it’s all dependent on what’s in the can (check the ingredients!). And as for nutrients?
Many canned fruits and vegetables contain more nutrients than fresh ones! This is because the way they’ve been stored preserves them better. For example:
- Canned tomatoes contain more bioavailable lycopene than fresh
- Canned spinach contains more bioavailable carotene than fresh
- Canned corn contains more bioavailable lutein than fresh
- The list goes on, but you get the idea!
Don’t Want To Take Our Word For It? Read The Scientific Paper Here!
Gaslight, Gymkeep, Girl-loss?
Many women and girls avoid doing weight-training as part of their exercise—or use only the smallest weights—to avoid “bulking up” and “looking like a man”.
Many men, meanwhile, wish it were that easy to bulk up!
The reality is that nobody, unless you have very rare genes, packs on a lot of muscle by accident. Even with the genes for it, it won’t happen unless you’re also eating for it!
Resistance-based strength training (such as lifting weights), is a great way for most people to look after an important part of their long-term health: bone density!
You can’t have strong muscles on weak bones, so strengthening the muscles cues the body to strengthen the bones. In short, your strength-training at age 45 or 55 (or earlier) could be what helps you avoid a broken hip at 65 or 75.
We’re Not Kidding, It Really Is That Important (Read The Study Here)!
Something doesn’t smell right about this
There’s been a big backlash against anti-perspirants and deodorants. The popular argument is that the aluminium in them causes cancer.
This led to many people buying “deodo-rocks”, crystal rocks that can be run under water and then rubbed on the armpits to deodorize “naturally”. But, those crystal rocks are actually alum crystals (guess what they contain…).
The belief that deodorants cause cancer came from studies done by applying deodorant to cells (like the canine kidney cells in this study) in petri dishes. So, assuming you don’t cut out your kidney and then spray it directly with the deodorant, the jury is still out!
A more recent systematic review sorted out quite clearly the ways in which aluminium was, or was not, harmful, and said:
❝Neither is there clear evidence to show use of Al-containing underarm antiperspirants or cosmetics increases the risk of Alzheimer’s Disease or breast cancer. Metallic Al, its oxides, and common Al salts have not been shown to be either genotoxic or carcinogenic.❞
Critical Reviews in Toxicology
…but also says that you should avoid eating aluminium while pregnant or breastfeeding. We hope you can resist the urge.
See The Summary For Yourself Here!
(actually the whole article is there, but we know you value condensed knowledge, so: the abstract at the top will probably tell you all you want to know!)
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The Pains That Good Posture Now Can Help You Avoid Later
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Dr. Murat Dalkilinç explains:
As a rule…
Posture is the foundation for all body movements and good posture helps the body adapt to stress.
Problems arise when poor posture causes muscles to overwork in ways that are not good for them, becoming tight or inhibited over time. Bad posture can lead to wear and tear on joints, increase accident risk, and make some organs (like the lungs, which feed everything else with the oxygen necessary for normal functioning) less efficient. It’s also of course linked to issues like scoliosis, tension headaches, and back pain, and can even affect emotions and pain sensitivity.
Good posture includes straight alignment of vertebrae when viewed from the front/back, and three natural curves in a (very!) gentle S-shape when viewed from the side. Proper posture allows for efficient movement, reduces fatigue, and minimizes muscle strain. For sitting posture, the neck should be vertical, shoulders relaxed, arms close to the body, and knees at a right angle with feet flat.
But really, one should avoid sitting, to whatever extent is reasonably possible. Standing is better than sitting; walking is better than standing. Movement is crucial, as being stationary for extended periods, even with good posture, is not good for our body.
Advices given include: adjust your environment, use ergonomic aids, wear supportive shoes, and keep moving. Regular movement and exercise keep muscles strong to support the body.
For more on all this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Beyond Just Good Posture: 6 Ways To Look After Your Back
Take care!
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How To Reduce The Harm Of Festive Drinking (Without Abstaining)
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How To Reduce The Harm Of Festive Drinking
Not drinking alcohol is—of course—the best way to avoid the harmful effects of alcohol. However, not everyone wants to abstain, especially at this time of year, so today we’re going to be focusing on harm reduction without abstinence.
If you do want to quit (or even reduce) drinking, you might like our previous article about that:
For everyone else, let’s press on with harm reduction:
Before You Drink
A common (reasonable, but often unhelpful) advice is “set yourself a limit”. The problem with this is that when we’re sober, “I will drink no more than n drinks” is easy. After the first drink, we start to feel differently about it.
So: delay your first drink of the day for as long as possible
That’s it, that’s the tip. The later you start drinking, not only will you likely drink less, but also, your liver will have had longer to finish processing whatever you drank last night, so it’s coming at the new drink(s) fresh.
On that note…
Watch your meds! Often, especially if we are taking medications that also tax our liver (acetaminophen / paracetamol / Tylenol is a fine example of this), we are at risk of having a bit of a build-up, like an office printer that still chewing on the last job while you’re trying to print the next.
Additionally: do indeed eat before you drink.
While You Drink
Do your best to drink slowly. While this can hit the same kind of problem as the “set yourself a limit” idea, in that once you start drinking you forget to drink slowly, it’s something to try for.
If your main reason for drinking is the social aspect, then merely having a drink in your hand is generally sufficient. You don’t need to be keeping pace with anyone.
It is further good to alternate your drinks with water. As in, between each alcoholic drink, have a glass of water. This helps in several ways:
- Hydrates you, which is good for your body’s recovery abilities
- Halves the amount of time you spend drinking
- Makes you less thirsty; it’s easy to think “I’m thirsty” and reach for an alcoholic drink that won’t actually help. So, it may slow down your drinking for that reason, too.
At the dinner table especially, it’s very reasonable to have two glasses, one filled with water. Nobody will be paying attention to which glass you drink from more often.
After You Drink
Even if you are not drunk, assume that you are.
Anything you wouldn’t let a drunk person in your care do, don’t do. Now is not the time to drive, have a shower, or do anything you wouldn’t let a child do in the kitchen.
Hospital Emergency Rooms, every year around this time, get filled up with people who thought they were fine and then had some accident.
The biggest risks from alcohol are:
- Accidents
- Heart attacks
- Things actually popularly associated with alcohol, e.g. alcohol poisoning etc
So, avoiding accidents is as important as, if not more important than, avoiding damage to your liver.
Drink some water, and eat something.
Fruit is great, as it restocks you on vitamins, minerals, and water, while being very easy to digest.
Go to bed.
There is a limit to how much trouble you can get into there. Sleep it off.
In the morning, do not do “hair of the dog”; drinking alcohol will temporarily alleviate a hangover, but only because it kicks your liver back into an earlier stage of processing the alcohol—it just prolongs the inevitable.
Have a good breakfast, instead. Remember, fruit is your friend (as explained above).
Want to know more?
Here’s a great service with a lot of further links to a lot more resources:
With You | How to safely detox from alcohol at home
Take care!
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