When steroids didn’t work, reader turned to acupuncture to help ease the pain.
Q: I am a doctor who has had dual meniscus knee surgeries. I found corticosteroid injection therapy useless for my knee pain. Surgery was ineffective in terms of reducing pain and discomfort, and the knee condition worsened after surgery. If this were not a medical procedure, I would have asked for a refund.
I’ve used MSM and glucosamine, but they take a long time before any effect is apparent. For fast results I have found acupuncture to be the gold standard in therapy. Along with ice and medical massage, acupuncture offered me the best result. I was so impressed that I studied acupuncture and now use it in my practice.
A: Your experience is consistent with the results of recent research. A double-blind placebo-controlled study published in JAMA (May 16, 2017) found that the steroid triamcinolone injected into the knee was no better than saline injections for arthritis pain relief. Knees exposed to the steroid lost cartilage more quickly, however.
As for surgery, a recent analysis of previous studies found no long-term advantages over conservative management strategies (BMJ Open, May 11, 2017). A group including surgeons, physiotherapists and patients has just issued guidelines discouraging arthroscopic surgery for knee arthritis and meniscus tears (BMJ, May 10, 2017).
We are glad to hear you have been so pleased with the results of acupuncture. Readers who would like to learn more about acupuncture and other nondrug approaches to managing arthritis pain will find details in our online Guide to Alternatives for Arthritis at PeoplesPharmacy.com.
Q: My wife told me about the mustard cure for muscle cramps some time ago. I thought it sounded wild, as I don’t understand how it would work.
Last week, I participated in a run/walk in Indianapolis with some old friends. Two of them ran a half marathon. After the race, we were sitting in a bar when one guy had a massive and painful cramp in his left quad. He is a well-trained runner, so the cramp was unusual.
Massage and stretching had no effect. I went to the unattended bar looking for anything that might help. I grabbed a slice of lime, not thinking it would make any difference, but willing to try whatever was at hand. My friend sucked on the lime and said the effect was essentially immediate! The cramp dissipated quickly. We joked about it for the rest of the day. I still don’t have an explanation.
A: Neuroscientists have shown that triggering special transient receptor potential channels in nerve cells can stop muscle cramps quickly (Muscle & Nerve, May 9, 2017). This is an elegant explanation for why tasting strong flavors like pickle juice, mustard, ginger or cinnamon can be helpful. Perhaps lime also stimulates TRP channels.