The Standard Journal

Truth about Joint pain

- By EDITORS Consumer Reports

A lifetime of wear and tear on your hips and knees makes joint pain almost inevitable. One in 2 adults will eventually develop achy knees caused by osteoarthr­itis, a condition marked by the gradual loss of the cartilage that cushions the ends of bones. One in 4 will develop hip pain from the condition.

The quest to ease discomfort is also inevitable, notes Consumer Reports. Stores are full of over-the-counter (OTC) drugs and supplement­s that manufactur­ers claim will provide relief. Doctors often recommend steroid injections or other shots, and hospitals tout the benefits of joint-replacemen­t surgery.

Many of those measures can help, but some don’t. Consumer Reports offers this guide to safely easing discomfort:

-- For Mild Pain: OTC Drugs

When to consider: Anyone with joint pain should start with lowimpact activities such as walking and swimming, combined with exercises to stretch and strengthen the legs. But you’ll probably need a pain reliever, too. Consider acetaminop­hen (Tylenol and generic) first. When taken in recommende­d doses, it’s safer than other OTC pain relievers, such as ibuprofen (Advil or generic) and naproxen (Aleve and generic). Reserve those drugs, which ease pain and reduce inflammati­on, for flare-ups. Another option: OTC creams containing capsaicin or methyl salicylate. Both stimulate nerves near the joint, creating a sensation that distracts you from the pain.

Stay-safe steps: The long-term use of acetaminop­hen can damage the liver, and frequent use of anti-inflammato­ries can cause stomach bleeding and increase the risk of high blood pressure, heart attack and stroke. People who drink a lot of alcohol or those who have liver disease should avoid acetaminop­hen; those with heart disease should use anti-inflammato­ries sparingly.

-- For Lingering Pain: Injections

When to consider: If you have pain or disability despite taking OTC drugs, ask your doctor about injections with steroids (which ease inflammati­on) or hyaluronic acid (which lubricate the joint).

Stay- safe steps: Hyaluronic acid provides only modest relief, according to a 2015 review in the New England Journal of Medicine, and up to 3 percent of people getting the shots have side effects such as worsened inflammati­on of the knee. So use it only if you don’t improve with other options but aren’t ready for surgery.

-- For Severe Pain: Joint Surgery

When to consider: About one million Americans get a knee or hip replaced each year, and most say it helps a lot. Still, both are major surgeries that, like all operations, pose risks of serious complicati­ons, and recovery can take months. So make sure you have tried other solutions, you understand the risks and recovery needed and you choose your surgeon and hospital carefully.

Stay-safe steps: Look for a surgeon who does at least 50 of the surgeries per year, preferably 100. Ask about his or her complicati­on and infection rates, and do some research. Two options: ProPublica’s surgeon tool ( projects. propublica. org/ surgeons) and healthgrad­es.com. Subscriber­s to Consumer Reports’ website can compare hospitals on complicati­on rates for hip and knee surgery and infections by going to ConsumerRe­ports. org/hospitalra­tings.

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