Couch potato in pain
DEAR DR. ROACH: I am a 72-year-old male disabled veteran. I started work out of high school in a factory where I did hard but not brutal work. Then went to Vietnam, where I injured my knee and had to be operated on. Next, I worked for an airline as a baggage handler then became a licensed aircraft mechanic, both of which were hard physical labour.
I have had one knee and one hip replaced, which was brutal and only slightly successful painwise. I now find myself with arthritis in most of my joints. My feet, knees, hips and back keep me from being active at all. I take 90 mg of narcotics per day from the Veterans Affairs doctor, which does not help very much but the pain is very bad when I forget to take them. I have had various shots in my knees and hips with diminishing results, acupuncture, physical therapy, etc., all to no avail.
My pain has turned me into a couch potato. This is very bad for my mental health. I try not to constantly complain to my wife. She helps me the best she can, but no one wants to be with someone who never leaves the couch. I heard about a new drug called tanezumab and that its clinical trials were canceled because it “worked too well.” Any advice?
ANSWER: Tanezumab is a novel drug and represents a potential new treatment for pain from osteoarthritis. It is a monoclonal antibody against nerve growth factor. There have been 39 trials on tanezumab, including promising trials showing reduction of pain and improvement of activity.
From a drug company perspective, there’s no such thing as a drug working “too well.” The most recent news I saw was that the Food and Drug
Administration was planning to make a decision as soon as December 2020. It’s possible a decision will be made while this column is in press.
Other advice I would give is that being a “couch potato” is just not good for osteoarthritis. Regular exercise of any kind helps reduce pain. I do understand you are in terrible pain and on opiates, but any kind of movement will help.
Being in a pool is one activity that virtually all of my patients with severe osteoarthritis can tolerate. You might check on what is available in your area. With so many joints affected, surgery may not be practical, but still ask your doctors at the VA their opinion on whether joint replacement surgery is worth considering.