#MIDDLEBURY
By Keith Roach, M.D.
DEAR DR. ROACH: I am a female in my 60s, and for the past couple of months I have been having some discomfort and swelling in my right knee. I am slightly overweight and have osteoarthritis. I have no pain when walking, but when leaning over, I get a tight pain in the front of the leg, below the knee. I saw my orthopedic doctor, who told me the cartilage is worn away, and said I would need a knee replacement. I was given a cortisone shot, which helped the pain.
Would losing weight help me avoid surgery? I take an anti-inflammatory and rubbed Bengay on the knee, which helped. I went for another opinion from a second orthopedic surgeon, had more X-rays taken and was given the same diagnosis. Is there anything more I can do to avoid having a knee replacement soon? – C.W.
ANSWER: Osteoarthritis of the knee can cause permanent loss of the cartilage. Once the cartilage is gone, the knee replacement is by far the best option to reduce pain and improve function. However, there are some things you can do to delay the need for surgery, as well as to feel better. Losing weight is important, if you are carrying more than you should. Your body weight is multiplied when you are going up and down stairs, so losing even a few pounds means much less pressure inside the knee.
Anti-inflammatories and Tylenol reduce pain but don’t affect the progression of disease. Bengay, topical anti-inflammatories and capsaicin creams help some people. Steroid injections are a good option for some: Hyaluronic acid shots, such as Synvisc, help many as well. Exercise, however, definitely improves both pain and function. Walking a little bit farther each day means being able to walk still more without pain.
A joint-replacement surgery shouldn’t be undertaken lightly. Not everybody has a good outcome, and an infection in an artificial joint can be devastating. However, it has been my experience that most people who have gotten a joint replacement wish they had done so sooner, so don’t suffer for too long if these treatments aren’t helping.
The arthritis booklet discusses osteoarthritis, along with rheumatoid arthritis and lupus. Readers can order a copy by writing: Dr. Roach – No. 301W, 628 Virginia Drive, Orlando, FL 32803. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. ROACH: What do you know about Himalayan salt? Is it harmful to take every day? I am told that it can help lower blood pressure, because it has minerals and trace elements. – M.S.
ANSWER: Himalayan salt, though it has a pretty pink color and trace minerals, is still almost all table salt – sodium chloride – and salt raises blood pressure for most people. Keeping sodium intake down is likely to reduce risk of heart disease and stroke. Generally, people with a healthy diet get all the trace minerals they need. Most studies on multivitamin and mineral supplements have shown no benefit.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803.
(c) 2016 North America Synd., Inc.
All Rights Reserved
